THE otolaryngologist is especially aware of the problems of regurgitation and aspiration during general anesthesia. In cases of trauma he must face this possibility in patients who may have recently eaten. In postoperative tonsillar bleeding he must assume that the stomach contains swallowed blood and is a potential aspiration danger, especially during induction. Vomiting during surgery need not be obvious for gastric material to enter the respiratory tract. Blitt et al1 studied this problem in 900 patients who had taken nothing by mouth for at least eight hours. Carmine red, an insoluble, inert, colloidally dispersed organic dye, was given orally to all patients. At the conclusion of the procedure the pharynx was inspected with a laryngoscope. Of the 900 patients, 70 (7.8%) "silently" regurgitated gastric contents. Of those patients who regurgitated, six (8.6%) were found to have aspirated. After reviewing the patients' records, the authors concluded the following:
Merifield DO. Anesthesiology 1970. Arch Otolaryngol. 1972;96(3):282–285. doi:https://doi.org/10.1001/archotol.1972.00770090404018
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