What increases risk for aspiration during anesthesia?

• A. When a patient has not been NPO prior to surgery (6-8 hours prior)
• B. When the patient has eaten a full meal the night before
• C. When the patient is fully hydrated
• D. When the patient has no contraindications to anesthesia

Answer: (A)

Not fasting before anesthesia increases the risk of aspiration because anesthesia relaxes the airway reflexes that normally protect the lungs from inhaling stomach contents. If the stomach still contains food or liquids, regurgitation can occur during induction or emergence, and these contents can be drawn into the lungs, leading to irritation or chemical pneumonitis. Following NPO guidelines keeps the stomach empty or with minimal contents, reducing that risk.

The other scenarios don’t fit as directly: having eaten a full meal before the planned time would also raise risk, but the key idea tested is the practice of being NPO to keep the stomach empty. Being fully hydrated or having no contraindications to anesthesia doesn’t inherently increase aspiration risk.