What is a recommended method to decrease reflux before general anesthesia?

To minimize the risk of aspiration during general anesthesia, the administration of a non-particulate antacid is recognized as an effective method to decrease gastric acidity and volume just prior to the procedure. Non-particulate antacids, such as citrate solutions, can raise the gastric pH without introducing particulate matter, thereby reducing the likelihood of complications such as aspiration pneumonia if reflux were to occur during anesthesia.

This preventive measure is especially important in patients who may have a full stomach or in emergency situations where fasting cannot be guaranteed. Non-particulate antacids can neutralize gastric acid to make the contents less harmful, allowing for safer intubation and anesthesia management.

In contrast, other options like diphenhydramine and sodium bicarbonate do not primarily serve the purpose of decreasing gastric acidity in the context of preparing for anesthesia, and metoclopramide, while it can help with gastric emptying, does not effectively address the issue of acidity in the stomach. Each adjunctive agent plays a role, but the use of non-particulate antacids specifically aligns with the goal of minimizing reflux complications associated with general anesthesia.