Vol. 7, Issue 2, Part A (2025)

Perioperative aspiration of gastric content is one of the most dreaded complications in Anaesthesia. It is associated with more than 9% of total anaesthesia related deaths and about 20% of hospital mortality, The American Society of Anaesthesiologists has laid down guidelines for fasting intervals in elective surgeries for all healthy patients. Despite this, these guidelines may not be reliable in all conditions and for all patients. Certain medical conditions like diabetics, patients with chronic kidney disease, obesity, parturient, gastrointestinal obstruction, incompetent LOS - hiatus hernia, previous gastrointestinal surgeries are all associated with delayed gastric emptying time and may present with more gastric content at the time of induction in spite of adequate fasting period. Gastric emptying is also hampered in stressful conditions in presence of pain, anxiety and use of certain drugs like opioids. Likewise prolonged fasting can also present with undesirable outcomes like anxiety, dehydration, hypotension, electrolyte imbalance, insulin resistance resulting in hypoglycaemia and increased risk of postoperative nausea and vomiting.
In all such situations bedside gastric ultrasound can act as a rescue tool for anaesthesiologist by helping them in not only deciding the appropriate plan of action for giving anaesthesia but also prevent the aspiration risk and catastrophes associated with it.