Risk Of Aspiration Research Articles

Effectiveness of vocal fold medialization surgery on the swallowing function of patients with unilateral vocal fold paralysis.

Vocal fold medialization surgery is generally considered a phonosurgical procedure for improvement of vocal function in patients with glottic insufficiency. However, the literature describing this procedure for the management of dysphagia is limited. This study aims to assess the effects of medialization surgery on swallowing function in patients with unilateral vocal fold paralysis (UVFP). We enrolled 32 patients with UVFP undergoing vocal fold medialization surgery (medialization laryngoplasty combined with arytenoid adduction [ML + AA], 12 cases; injection laryngoplasty [IL], 20 cases). We assessed the aerodynamic vocal function including maximum phonation time and mean flow rate to evaluate glottal closure status. The Hyodo score determined by flexible endoscopic evaluation and Functional Oral Intake Scale (FOIS) were evaluated pre- and postoperatively. Almost 60% of patients with UVFP had dysphagia, and one-third were at high risk for aspiration. Aerodynamic parameters effectively improved after IL and ML + AA. With regard to swallowing, both the FOIS and total Hyodo score were significantly improved postoperatively. We found a particularly significant improvement in pharyngeal clearance. However, patients with high vagal nerve paralysis and postoperative insufficient glottal closure showed poor swallowing benefits after the interventions. In patients with recurrent laryngeal nerve palsy, there were no significant differences in postoperative swallowing function between the ML + AA and IL groups. Vocal fold medialization surgery was effective in improving swallowing function in most cases with UVFP, except for those with high vagal paralysis and insufficient postoperative glottal closure. Both IL and ML + AA showed an equivalent effect on swallowing improvement. 3b.

Reconstruction of subtotal pharyngolaryngectomy using a fasciocutaneous free flap with cartilage graft: A case series of 17 patients.

Subcricoid-hemilaryngopharyngectomy (SCHLP) with a reconstruction using a fasciocutaneous free flap armed with cartilage graft (FFACG) aims to avoid permanent tracheostomy while still maintaining the laryngopharyngeal functions. The purpose of this study is to report the outcome of this surgical approach. Retrospective study including 17 men operated between 2001 and 2019. Specific survival rate included death caused by cancer or SCHLP complications. Complications, functional and oncological outcomes were evaluated retrospectively. There were no locoregional recurrences. One patient died due to inhalation pneumonia 3 years after surgery. Tracheostomy was closed in 13 patients (76.5%). Mean decannulation time was at six [1-14] months after surgery. SCHPL with FFACG could avoid total pharyngolaryngectomy with good oncologic results. However, tracheotomy is extended and deglutition recovery is long with high risk of aspirations. These complications justify that such surgery should be realized only on selected patients by experienced surgical teams. Expertise of the surgical team is critical.

Ultrasound assessment of gastric residual volume in patients over 60 years of age undergoing gastroscopy under sedation: a prospective cohort study.

We aimed to assess the accuracy of ultrasonographic measurement of the antral cross-sectional area (CSA) in the preprocedural evaluation of gastric contents and volume in fasted patients > 60 yr of age scheduled for gastroscopy under sedation. We included n = 81 patients > 60 yr of age and n = 79 younger controls scheduled to undergo elective gastroscopy in a prospective cohort study. A gastric ultrasound examination was performed to measure the antral CSA in both semisitting and right lateral decubitus (RLD) positions. Afterward, patients were graded using the Perlas qualitative grading scale. The actual gastric volume was endoscopically suctioned. Full stomach was defined as gastric volume > 1.5 mL·kg-1 and/or the presence of solid particles. We constructed receiver operating characteristic curves to determine the accuracy of ultrasonographic measurement of RLD CSA to detect a gastric volume > 1.5 mL·kg-1 and calculated the diagnostic test attributes of RLD CSA for the identification of a gastric volume > 1.5 mL·kg-1 RESULTS: The incidence of full stomach was 8/81 (9.8%) in patients > 60 yr of age and 1/79 (1.2%) in young patients (risk difference, 8.6%; 95% CI, 1.3 to 15.8; P=0.03). The cut-off value of RLD CSA was 10.4 cm2 for the detection of gastric volume > 1.5 mL·kg-1 in patients > 60 yr of age, with a sensitivity of 75%, a specificity of 100%, a positive predictive value of 100%, and a negative predictive value of 98.6%. Patients > 60 yr of age scheduled for gastroscopy under sedation had a higher incidence of a full stomach detected with ultrasound compared with a younger cohort, which is potentially associated with a higher aspiration risk. We calculated a cut-off value of RLD CSA for detecting gastric volume in patients > 60 yr of age of approximately 10 cm2, which may help to quickly assess patients at risk of aspiration. www.chictr.org.cn (ChiCTR2100048994); registered 19 July 2021.

Anaesthesia Management of a Parturient with Klippel Feil Syndrome Undergoing Emergency Cesarean Section

Klippel Feil syndrome (KFS) is a rare autosomal genetic disorder comprising of classical triad of short neck, low hairline, and limited neck mobility. Parturient with KFS syndrome presents with difficult airway and needs individualized consideration for Anaesthesia. Management with Regional Anaesthesia has its pros and cons and can be considered in parturient with KFS as General Anaesthesia in pregnancy poses increased risk of aspiration, difficult mask ventilation and endotracheal intubation. We present a case of a 25-yr old parturient G3A2 with 34+4 weeks of gestation with KFS syndrome posted for emergency caesarean section managed successfully under spinal anaesthesia.

Validation of dysphagia perception to predict the risk for dysphagia in non-institutionalized older adults

Dysphagia is a swallowing disorder that affects mainly the older adults and can compromise quality of life, and increase the risk for malnutrition and aspiration. Early diagnosis is, therefore, essential to prevent adversities. We aimed to evaluate the validity of self-perceived dysphagia in community-dwelling older adults (60 years or older) from Pelotas, Brazil, participants in the "COMO VAI?" The Eating Assessment Tool (EAT-10) was used as the reference tool to identify the risk for dysphagia and the self-perception of dysphagia was assessed using the following question: "Do you have swallowing difficulties?" (Yes/No). The parameters of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were described with 95% confidence intervals (95% CI) and according to independent variables (sex, age, economic level, and education). The prevalence of dysphagia risk according to EAT-10 and self-perception was 12.9% (95% CI 10.2-16.1) and 8.8% (95% CI 6.6-11.6), respectively. Sensitivity was 34.8% (95% CI 23.5-47.6) and the highest values were observed in women and the older individuals (80 years or older). Specificity was 95.1% (95% CI 92.6-96.9). PPV was 51.1% (95% CI 35.8-66.3), NPV 90.8% (95% CI 87.8-93.2) and accuracy 87.3%. Considering the low sensitivity and PPV, the self-perception of dysphagia analyzed with a single question should be used with caution, as an individual at risk for dysphagia may not realize their condition.

COMPARISON BETWEEN BASKA MASK AND I-Gel INSERTION IN MINOR SURGERIESUNDER GENERAL ANAESTHESIA IN PATIENT AGED 18-50 Y:-A RANDOMIZEDINTERVENTIONAL STUDY

Objective: The supraglottic airway (SAD) is considered a viable alternative to endotracheal intubation, particularly in cases where SAD is not contraindicated. SAD plays a crucial role in difficult airway algorithms, offering unobstructed oxygenation and ventilation, as well as providing hemodynamic stability with minimal laryngopharyngeal morbidity. The LMA-classic, introduced by Archie Brain in 1983, was the first second-generation SAD used in clinical practice. Over time, numerous advancements have led to the development of improved second-generation SADs.
 Methods: This study aims to compare the efficacy and advantages of different supraglottic airway devices. Two types of second-generation SADs were evaluated:I-gel (Intersurgical, Wokingham, UK) and a novel device called Baska Mask, which belongs to the third generation of SADs. The evaluation criteria included ease of insertion, oropharyngeal sealing pressure, ability to drain gastric fluid, prevention of malposition, sealing pressure during controlled ventilation and spontaneous breathing, and reduction of respiratory complications.
 Results: The second-generation SADs, including the I-gel, are easy to insert and offer high oropharyngeal sealing pressure. They have a gastric channel to drain gastric fluid, reducing aspiration risk. The I-gel, a new latex-free SAD with a noninflatable cuff made of medical-grade thermoplastic elastomer, provides a superior seal, resulting in lower respiratory complications compared to earlier SADs. It ensures effective sealing during controlled ventilation and spontaneous breathing. The third-generation Baska Mask combines the advantages of second-generation LMAs and provides higher seal pressure during IPPV by apposing to the glottis, distinguishing it from non-inflatable cuff devices like the I-gel.
 Conclusion: Supraglottic airway devices, particularly second-generation SADs like I-gel, offer effective airway management alternatives to endotracheal intubation. These devices provide ease of insertion, high oropharyngeal sealing pressure, and the ability to drain gastric fluid, reducing the risk of complications. The third-generation device, Baska Mask, exhibits enhanced seal pressure during IPPV, making it a promising advancement in airway management.

Impacts of body positions on the geniohyoid muscle contraction and swallowing difficulty in healthy adults.

Body positions affect swallowing and gastroesophageal reflux. Swallowing impairment is one of the main causes of aspiration pneumonia. To prevent pneumonia, evaluation of body positions on gastroesophageal reflux recommended 30 degrees or higher semi-recumbent positions. The geniohypoid muscle and tongue play central roles in swallowing. However, the effects of body positions on contracting rates in the geniohyoid muscle and tongue pressure are unclear. Moreover, correlations between geniohyoid muscle contracting rates and subjective swallowing difficulties are unclear. This study aimed to identify the proper body positions on contracting rates in the geniohyoid muscle, tongue pressure, and subjective swallowing difficulties. Twenty healthy adults swallowed 15- or 50 ml of water at 90 degrees sitting, 60- and 30 degrees semi-recumbent, and 0 degrees supine positions. We scored the subjective swallowing difficulties and measured the tongue pressure and the number of swallows. An ultrasound evaluated the geniohyoid muscle size and contracting rates. At sitting and 60 degrees semi-recumbent positions, the geniohyoid muscle showed greter contracting rates than at 30 degrees semi-recumbent and supine postions (P < 0.05), which resulted in easier swalloiwng. Greater tongue pressure was weakly correlated with fewer swallows (r = -0.339, P = 0.002), whereas the body positions did not affect. Considering swallowing and gastroesophageal reflux together, a trunk angle of 60 degrees or more might be beneficial for reducing the risk of aspiration.

Promoting Patient-Centered Fasting Through E-Mail Reminders

Abstract Historical fasting practices before 1999 advised that surgical patients should have nothing to eat or drink after midnight to minimize the risk of aspiration. This practice can lead to prolonged fasting from food and liquids, which causes irritability, hunger, excessive thirst, and stress for the child and their caregiver. In addition, an increased inflammatory response and insulin resistance can occur during surgery. Research has demonstrated that fasting from clear liquids for 1–2 hours before surgery does not increase the risk of aspiration in children. A pre- and post-intervention quality improvement project was conducted in a pediatric surgical department in central Florida. From March to August 2022, 346 parents of children scheduled for general surgery were included in the project. Both groups received a reminder phone call the day before surgery with their preoperative instructions. In addition to a phone call, the post-intervention group also received an e-mail summarizing fasting instructions and times. This quality improvement project compared fasting times from food, nonclear liquids, and clear liquids before and after implementing an e-mail message reminder. The mean fasting times for clear and nonclear liquids did not change significantly from the baseline group to the post-intervention group. However, the mean solid fasting times did decrease significantly from 13.8 to 12.9 hours (p &lt; .05) in the post-intervention group. Sending an e-mail reminder the day before surgery significantly reduced the mean fasting times for food. However, additional interventions and parental education may be needed to promote a reduction in fasting from clear and nonclear liquids.

Dysphagia and pulmonary complications in acute cerebrovascular disease: A retrospective observational study

IntroductionDysphagia is a common post-stroke complication, which may result in serious pulmonary sequelae. Early detection of dysphagia and aspiration risk can reduce morbidity, mortality and length of hospitalization. ObjectivesThis study aims to identify association between dysphagia and acute cerebrovascular disease, and evaluate the prevalence and impact of pulmonary complications on readmissions and mortality. Material and methodsRetrospective observational study based on 250 clinical records of patients with acute cerebrovascular disease: clinical history, neurological examination, imaging and Gugging Swallowing Screen in the first 48h. Patients were followed for 3 months via medical records to estimate 3-month mortality and readmissions. ResultsOut of 250 clinical records analyzed, 102 (40.8%) were evaluated for dysphagia. The prevalence of dysphagia was 32.4%. The risk was higher in older patients (p<0.001), in severe stroke (p<0.001) and in the hemorrhagic subtype (p=0.008). An association was found with dysarthria and aphasia (p=0.003; p=0.017). Respiratory tract infections occurred in 14.4% of all patients (GUSS group 11.8% versus no GUSS group 16.2%), and in 75% of those with severe dysphagia (p<0.001). Mortality at 3 months was 24.2% in dysphagic patients, especially high in the severe dysphagia group (75%, p<0.001). ConclusionsThe type of cerebrovascular disease, NIHSS and GCS scores, age, dysarthria, and aphasia were significant associated factors to dysphagia. The prevalence of respiratory tract infections was higher in patients with no GUSS record, and no statistical significance was observed in related readmissions. Mortality at 3 months was superior in the severe dysphagia group.

Comparison of intracuff alkalinized 2% lignocaine versus dexamethasone for attenuation of post operative laryngotracheal morbidity: a randomized comparative study

Introduction: This randomized comparative study was planned to compare intracuff alkalinized lignocaine versus dexamethasone in preventing postoperative laryngotracheal morbidity. During general anesthesia patients were intubated with cuffed endotracheal tubes to provide effective positive pressure ventilation as well to prevent risk of aspiration. The cuffs of endotracheal tubes were inflated with air. This air in these cuffed endotracheal tubes can cause significant laryngotracheal morbidity. So, we planned this study to find a better substitute other than air to prevent postoperative laryngotracheal morbidity. Material and methods: Total 56 cases were taken. In group A, the cuff of the endotracheal tube was filled with 2% lignocaine 2 ml (40 mg) and sodium bicarbonate (NaHCO3 8.4%) 1 ml (total 3 ml volume). In Group B, the cuff of the endotracheal tube was filled with dexamethasone (8 mg) 2 ml with 1 ml NS (total 3 ml volume). Results: The incidence of sore throat and hoarseness was less in the alkalinized lignocaine group. (p value &gt; 0.05). While the incidence of coughing was roughly similar in both groups and at different time intervals (P value &gt;0.05). Conclusion: Intracuff alkalinized Lignocaine in comparison to intracuff dexamethasone causes less incidence of sore throat and hoarseness in post operative period thus improved patient comfort levels and better recovery profile.

Innovative Swallowing Rehabilitation Balloon and Its Impact on Swallowing Outcomes in Home-Based Stroke Cases in Taiwan: Study Protocol for Randomized Controlled Trial

We outlined a randomized controlled trial assessing the effect of a novel swallowing rehabilitation balloon on post-stroke dysphagia in home-based care. Stroke often causes dysphagia, and standard rehabilitation methods have limitations, prompting the need for innovative interventions. Stroke-induced dysphagia is challenging as it requires improved interventions beyond current limitations. The effect of the swallowing balloon’s impact on aspiration efficiency was assessed in and risk of the trial with stroke patients. Patient satisfaction, compliance, and cost-effectiveness were also evaluated. The outcome showed better swallowing and reduced risk of aspiration were achieved. This indicated the effectiveness of home-based balloon therapy. This novel approach enhances post-stroke dysphagia rehab, improves patients’ health, and reduces healthcare costs.

Comparison of intracuff alkalinized 2% lignocaine versus dexamethasone for attenuation of post operative laryngotracheal morbidity: a randomized comparative study

Introduction: This randomized comparative study was planned to compare intracuff alkalinized lignocaine versus dexamethasone in preventing postoperative laryngotracheal morbidity. During general anesthesia patients were intubated with cuffed endotracheal tubes to provide effective positive pressure ventilation as well to prevent risk of aspiration. The cuffs of endotracheal tubes were inflated with air. This air in these cuffed endotracheal tubes can cause significant laryngotracheal morbidity. So, we planned this study to find a better substitute other than air to prevent postoperative laryngotracheal morbidity. Material and methods: Total 56 cases were taken. In group A, the cuff of the endotracheal tube was filled with 2% lignocaine 2 ml (40 mg) and sodium bicarbonate (NaHCO3 8.4%) 1 ml (total 3 ml volume). In Group B, the cuff of the endotracheal tube was filled with dexamethasone (8 mg) 2 ml with 1 ml NS (total 3 ml volume). Results: The incidence of sore throat and hoarseness was less in the alkalinized lignocaine group. (p value &gt; 0.05). While the incidence of coughing was roughly similar in both groups and at different time intervals (P value &gt;0.05). Conclusion: Intracuff alkalinized Lignocaine in comparison to intracuff dexamethasone causes less incidence of sore throat and hoarseness in post operative period thus improved patient comfort levels and better recovery profile.

Flexible endoscopic evaluation of swallowing in neurology

Neurogenic dysphagia is afrequent symptom in avariety of neurological diseases. The establishment of the flexible endoscopic evaluation of swallowing (FEES) in the field of neurology has led to improvements in the diagnostics and treatment of patients with dysphagia. The aim of this review is to present the development of the FEES examination in the field of neurology. Furthermore, the additive value in the diagnostic classification of neurogenic dysphagia is elucidated and the impact on treatment management in patients with dysphagia is highlighted. Narrative literature review. The FEES examination is asafe and well-tolerated method for the diagnostics of neurogenic dysphagia. It enables the valid investigation of the swallowing function within the very heterogeneous neurological patient population. It has become an important diagnostic tool, not only in the assessment of the severity of dysphagia and the risk of aspiration but also as areliable method for the etiological classification of symptoms of deglutition disorders. As FEES can be performed at the bedside and does not require radiation exposure, it can be used not only to examine critically ill patients (point of care diagnostics) but also to monitor treatment. The systematic endoscopic evaluation of swallowing is established as an important functional diagnostic tool in the field of neurology. Further developments to increase the use of FEES in clinically related disciplines such as neurosurgery, neuro-oncology or psychiatry are pending.

Anaesthesia for a child with α-dystroglycan-related congenital muscular dystrophy

α-Dystroglycanopathy is a newly emerging subcategory of autosomal recessive inherited muscular dystrophies which encompasses a wide spectrum of clinical severity. Mutation of at least 18 genes which are responsible for O-mannose glycosylation of α-dystroglycan has been linked to these congenital muscular dystrophy phenotypes. α-Dystroglycan-related congenital muscular dystrophy (αDG-CMD), which may be associated with multisystem involvement, poses a challenge in perioperative management. Yet, there is a dearth of resources available for reference. We report successful anaesthesia for a 6-year-old child with αDG-CMD who underwent bilateral hamstring lengthening, left Achilles tendon lengthening, and above-the-knee fibreglass for bilateral hamstring tightness. Anaesthesia was performed using total intravenous anaesthesia (TIVA) without muscle relaxant. Bilateral sciatic nerve blocks were performed for postoperative pain control, allowing opioid-free analgesia. The patient was extubated at the end of the surgery. Perioperative considerations in αDG-CMD include anticipation of difficult airway, maintenance of thermoregulation and precautions against malignant hyperthermia with the employment of TIVA, techniques that avoid opioids and neuromuscular blocking agents (particularly suxamethonium), as well as minimizing the risk of aspiration and of raised intracranial pressure.

Dysphagia screening post-stroke: systematic review

Background/scopeStroke is one of the main causes of death, especially when associated with dysphagia. Hence, the assessment of nutritional status and aspiration risk is important to improve clinical outcomes. The...

INFLUENCE OF THE NAUSEA AND VOMITING REFLEX IN PROSTHETIC TREATMENT OF PATIENTS WITH HOMEOPATHIC MEDICINES - A CASE REPORT

Prosthetic treatment of a patient with manifested nausea reflex could be a dramatic experience. There is a risk of aspiration or ingestion of foreign objects, and the dentist may have great difficulties during the procedures. Purpose: The purpose is to report the efficiency of homeopathic medicines in the case of prosthetic treatment with removable dentures of a patient with a gag reflex and several medical conditions. There is a risk of aspiration of foreign bodies. This leads to compromises in the final treatment quality and difficulty wearing a denture because of gagging. Homeopathy is a safe and natural alternative that finds application in dentistry. Material/Methods: A case of a female patient is reported. Age of 63 with accompanying diseases. The patient has an exaggerated gag reflex during intraoral examination and needs prosthetic treatment with removable dentures. The gag reflex was assessed by the Classification of Gagging Problem Index (CGP), and examination of reflex reaction with a sterile swab and monofilaments were done before and after the reception of homeopathic medicines. Results: During the first and second visits, the results of the CGP index were recorded in the patient's clinical record. The results of the tests with the monofilaments and the sterile swab before and after taking homeopathic medicines were filled in tables and were compared. Conclusions: A satisfactory, harmless and long-lasting result in the reduction of the nausea reflex is achieved in the reported case by homeopathic medicines. All clinical stages of removable dentures' fabrication were possible, and the patient tolerated the new prostheses pretty well.

Dens connatalis – A rare case report of natal teeth with literature review

It is unusual for babies to have teeth at birth or within a month of delivery. For a good differential diagnosis of whether there are extra teeth, Bhon nodules, or dental lamina cysts, a proper clinical and radiographic examination is required. The clinic branch received a rare case of natal teeth for this report's subject. An 18-day-old male new-born was checked because he had two mandibular incisor natal teeth. Because of the risk of aspiration and the patient's refusal to eat, the movable teeth had to be removed. Each patient is assessed individually to determine the best course of treatment, which may involve observation, tooth whitening, or extraction.

Evaluation of Esophageal Dysphagia in Elderly Patients.

While guidelines exist for the evaluation and management of esophageal dysphagia in the general population, dysphagia disproportionately affects the elderly. In this article, we reviewed the literature on evaluating esophageal dysphagia in elderly patients and proposed a diagnostic algorithm based on this evidence. In older patients, dysphagia is often well compensated for by altered eating habits and physiologic changes, underreported by patients, and missed by healthcare providers. Once identified, dysphagia should be differentiated into oropharyngeal and esophageal dysphagia to guide diagnostic workup. For esophageal dysphagia, this review proposes starting with endoscopy with biopsies, given its relative safety even in older patients and potential for interventional therapy. If endoscopy shows a structural or mechanical cause, then further cross-sectional imaging should be considered to assess for extrinsic compression, and same session endoscopic dilation should be considered for strictures. If biopsies and endoscopy are normal, then esophageal dysmotility is more likely, and high-resolution manometry and additional workup should be performed following the updated Chicago Classification. Even after diagnosis of the root cause, complications including malnutrition and aspiration pneumonia should also be assessed and monitored, as they both result from and can further contribute to dysphagia. The successful evaluation of esophageal dysphagia in elderly patients requires a thorough, standardized approach to collecting a history, selection of appropriate diagnostic workup, and assessment of risk of potential complications, including malnutrition and aspiration.

Patients' Knowledge About the Endoscopic UltrasoundGuided Fine Needle Aspiration of Pancreas Is Not Enough.

The aim of the study is to evaluate the extent to which patients acquired necessary knowledge about pancreatic endoscopic ultrasound-guided fine needle aspiration and assess what should be more focused on in the informed consent process. Adult patients enrolled in this study had pancreatic lesions confirmed by regular imaging and planned to undergo the first pancreatic endoscopic ultrasound-guided fine needle aspiration. These patients were asked to complete a questionnaire, including indications, possible results, downstream events, the risk for false-negative and malignant lesions, and so on. Then we conducted a longterm follow-up of these patients to obtain the final results. Most people (94.25%) correctly recognized that the indication of pancreatic endoscopic ultrasound-guided fine needle aspiration was to exclude malignant lesions. Almost all patients knew that the results could be benign or malignant, while the number of people who were aware of non-diagnostic (22%), indeterminate (18%) outcomes, and the possibility of further testing (20%) after the endoscopic ultrasound-guided fine needle aspiration has decreased significantly. Finally, we got that the false-negative rate and percentages of malignancy were 17.81% and 83.91%, while 98% of participants did not recognize that there is a false-negative risk of endoscopic ultrasound-guided fine needle aspiration and more than 2/3 of participants did not know how much risk they might have for malignant lesions. A high proportion of patients who received endoscopic ultrasound-guided fine needle aspiration could identify the indication for this procedure but remained unaware of possible outcomes, downstream events, especially the risk for false-negative and malignant lesions. It is necessary to improve the quality of dialogue between clinicians and patients, and the information about the risk of false-negative and malignancy may need to be emphasized in the informed consent process.

Assessment of preoperative preventive measures for pulmonary aspiration in surgical patients: A cross-sectional study

BackgroundPulmonary aspiration of gastric contents is a rare but catastrophic cause of anesthesia related morbidity and mortality of surgical patients. The risk of pulmonary aspiration is high in surgical patient due to multiple factors. The aim of this study was to assess the practice of aspiration prevention and prophylaxis usage for patients prior to surgery. MethodA cross-sectional study was conducted from 10 April 2022 to 20 April 2022. Data were collected by the direct observation and patient interview. The standards were directly changed in to questionnaire form with two integral components ‘yes’ and ‘no”. Data were entered and analyzed using statistical package of social sciences (SPSS) version 20. ResultA total of 200 surgical patients were included with a response rate of 100%. Preoperative information provision to elective surgical patients on fasting requirements and the reason for them in advance of their procedures was implemented in 63% of the patients. The verification of fasting requirement was provided in 94% of elective patients. About 62.5% of elective surgical patients received gastrointestinal stimulants preoperatively. Metoclopromide was administered for 94% of emergency patients. Conclusion and recommendationThe practice of preoperative fasting and administration of prophylactic agents for pulmonary aspiration is quite limited in our setup. Moreover, adherence to the recommendations of American Society of Anesthesiologist (ASA) and European Society of Anesthesiologist (ESA) was also suboptimal. We strongly recommend clinicians to use appropriate prophylactic agent to the right patient and adherence of the clinician to the local guideline on prevention of pulmonary aspiration.