Incidence and complications of the aspiration of gastric contents syndrome during cesarean section in general anesthesia

Maternal mortality attributed to anaesthesia, decreased in the last twenty years, has in inhalation of gastric contents one of its principal causes. Pregnant women are considered "high risk". In this retrospective investigation we studied 12,380 patients undergoing caesarean section in general anaesthesia between January 1977 and December 1991. During this period of obstetric activity the frequency of aspiration syndrome is 1:1,547 general anaesthesias (0.064%), being the 61.5% of all anaesthetic complications. In the 8 patients we had no maternal and neonatal mortality. Aspiration pneumonitis occurred in three patients. All patients were admitted at our recovery room for less than 5 days. The emergency procedure (8 cases) and a difficult tracheal intubation (4 cases) are the more important risk factors. In our clinical practice we used prevention in few cases (3.1%). Our results suggest the utility in obstetric anaesthesia of high doses of thiopental (5-6 mg/kg); these doses didn't change the principal neonatal parameters, while give in pregnant woman a light anaesthesia.