Regurgitation and aspiration

Regurgitation and aspiration remains one of the major complications of general anaesthesia. Aspiration is defined as oropharyngeal or gastric content entering the airway below the level of the vocal cords. This can cause morbidity and mortality by direct effects of the particulate, acid-related damage and bacterial pneumonia. It occurs largely in patients with risk factors although occasionally in patients that are low risk. Anaesthetic technique should be adjusted depending on the patient's risk of aspiration with rapid sequence induction considered in high-risk patients. Recognition and appropriate management of aspiration is essential.