Airway management concerns in patient with gastric banding procedures.
Laparoscopic adjustable gastric band (LAGB) is considered a relatively safe and effective treatment for obesity. Even after weight loss patients with LAGB are at increased risk of pulmonary aspiration during induction of general anaesthesia, possibly due to LAGB-induced anatomical and functional changes. We present a case of aspiration in a patient with LAGB following significant weight loss and 14 h of preoperative fasting and review the literature. In the presence of LAGB we propose specific anaesthesia management at least consisting of anti-Trendelenburg positioning; avoidance of mask-ventilation; use of the local rapid sequence induction strategy with endotracheal intubation and fully awake extubation.
Department of Anaesthesiology, St Elisabeth Hospital, Tilburg, The Netherlands.
Jasper
J
Koolwijk
Marcel
M
Schors
Soufian
S
el Bouazati
Gerrit J
GJ
Noordergraaf
D058109:Airway Management / Q000379:methods*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods; D010535:Laparoscopy; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011015:Pneumonia, Aspiration / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications; D013396:Suction; D014132:Trachea
D000900:Anti-Bacterial Agents