Gastric volume and pH in children for emergency surgery

The volume and pH of gastric contents aspirated prior to anaesthesia were measured in 101 children admitted for emergency surgery. The children were aged between 3 months and 15 years. If we define potential patients at risk by means of the volume and pH of the gastric contents, then 50.0% of the children were at risk of aspiration into the lungs. The number of patients at risk was higher in children aged between 6 and 10 years. There was almost the same risk in the groups with abdominal-, urogenital-, and orthopaedic diseases, while the number of patients at risk was less in the group with superficial lesions. The length of fasting time in the child considerably influenced the volume of gastric contents in emergency surgical cases. It is concluded that in children admitted for emergency surgery there is a risk of aspiration of gastric contents into the lungs. The risk is reduced by preanaesthetic fasting. All children admitted for emergency surgery must be carefully evaluated prior to anaesthesia with special reference to gastric aspiration.