空腹患者在使用塞马鲁肽和麻醉过程中发生肺吸入的风险:一份有断层扫描证据的病例报告。

IF 1.1 Q2 MEDICINE, GENERAL & INTERNAL
Einstein-Sao Paulo Pub Date : 2023-12-15 eCollection Date: 2023-01-01 DOI:10.31744/einstein_journal/2023RC0628
Veronica Neves Fialho Queiroz, Priscila Mina Falsarella, Renato Carneiro de Freitas Chaves, Flávio Takaoka, Luis Ricardo Socolowski, Rodrigo Gobbo Garcia
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引用次数: 0

摘要

麻醉期间将胃残留物吸入肺部是一种潜在的致命并发症,目前尚无特效治疗方法。在择期手术中,防止其发生的主要方法是遵守禁食方案。然而,某些临床症状会延长胃排空时间,因此尽管充分禁食,仍可能存在吸入风险。认识到胃痉挛的风险因素,就可以采取预防措施,这也是降低肺吸入发病率和死亡率的主要方法。在这种情况下,麻醉师可以使用超声波检查胃内容物,调整麻醉技术,甚至推迟择期手术。在此,我们描述了一名患者在未事先识别胃瘫风险因素的情况下偶然通过计算机断层扫描发现胃内有固体内容物。患者在禁食 9 小时后,在全身麻醉下接受了择期肾结节消融术。手术过程中,计算机断层扫描发现胃内有固体内容物。随后,医生发现患者已使用塞马鲁肽 6 天,但并未透露这一信息。使用塞马鲁肽可能是麻醉相关肺吸入的一个新的重要风险因素。在有关使用塞马鲁肽的患者的适当围术期管理的研究提供相关信息之前,麻醉医师需要采取预防措施以避免吸入。认识到这种潜在的关联性以及患者、医生和麻醉团队之间的坦诚交流对于提高患者安全至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Risk of pulmonary aspiration during semaglutide use and anesthesia in a fasting patient: a case report with tomographic evidence.

Pulmonary aspiration of gastric residues during anesthesia is a potentially fatal complication for which no specific treatment is available. The primary way to prevent its occurrence in the context of elective surgeries is adherence to fasting protocols. However, some clinical conditions can prolong the gastric emptying time, and the risk of aspiration may exist despite adequate fasting. Recognizing the risk factors for gastroparesis allows the adoption of preventive methods and is the primary way to reduce morbidity and mortality from pulmonary aspiration. In this scenario, the anesthesiologist can investigate the gastric content by using ultrasound, adjust the anesthetic technique, and even postpone elective surgeries. Here, we describe incidental computed tomography finding of solid contents in the stomach of a patient without prior identification of the risk factors for gastroparesis. The patient underwent elective renal nodule ablation under general anesthesia after fasting for 9 hours. During the procedure, solid contents in the stomach were noted on computed tomography. Subsequently, it was discovered that the patient had been using semaglutide for 6 days and had not disclosed this information. Semaglutide use may represent a new and significant risk factor for anesthesia-related pulmonary aspiration. Until studies provide information on the appropriate perioperative management of patients using semaglutide, anesthesiologists need to adopt preventive measures to avoid aspiration. Awareness of this potential association and open communication among patients, physicians, and anesthesia teams are essential for enhancing patient safety.

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来源期刊
Einstein-Sao Paulo
Einstein-Sao Paulo MEDICINE, GENERAL & INTERNAL-
CiteScore
2.00
自引率
0.00%
发文量
210
审稿时长
38 weeks
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