A review of the role of gastric ultrasound in anaesthesia planning for emergency surgery patients
Published Online: Jul 29, 2025
Abstract
Pulmonary aspiration is a life-threatening complication in emergency surgery, with a mortality rate of 6.6%. The incidence is 1 in 2,000-3,000 cases, and it occurs 4.5 times more frequently than in elective procedures. Although Rapid Sequence Induction (RSI) helps reduce the risk of aspiration, it can also increase the risk of adverse events, such as an undetected difficult airway, hypotension, and hypoxemia during induction. Identifying risk factors related to the patient's condition, surgical impact, and effects of the anesthesia technique is crucial in planning optimal perioperative management for each patient. Gastric ultrasound is an effective tool for anesthesia planning in emergency surgery. It helps assess stomach contents, which in turn minimizes the risk of aspiration and the need for unnecessary rapid sequence induction (RSI). With 95% sensitivity and 88-95% specificity, it allows for precise risk stratification. A practical flowchart guides decisions on surgical timing and anesthesia techniques, ultimately reducing complications like aspiration and improving patient safety by tailoring care to the patient’s gastric status.