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门诊环境中克罗恩病相关的隐匿性误吸:麻醉医生需警惕。

Crohn's disease-associated silent aspiration in the outpatient setting: Anesthesiologists beware.

作者信息

Snell Christopher, Coleman Scott, Van Hal Michele, Rashidian Farshad, Okum Gary, Green Michael Stuart

机构信息

Department of Anesthesia, Drexel University College of Medicine, Hahnemann University Hospital, Philadelphia, PA, USA.

出版信息

Saudi J Anaesth. 2018 Apr-Jun;12(2):339-342. doi: 10.4103/sja.SJA_663_17.

Abstract

Every anesthesia provider fears aspiration of gastric contents during an anesthetic, and it may occur even in the absence of overt signs such as coughing or choking. Whether the aspiration is frank or silent, catastrophic and deleterious consequences may ensue. Therefore, familiarity with risk factors for silent aspiration is essential. Crohn's disease reportedly delays gastric emptying making these patients more susceptible to silent aspiration during surgery. Anesthesia providers must be cognizant of this risk and vigilant in the recognition to formulate a specific treatment plan preoperatively. We present a case of an ambulatory surgical patient with suspected silent aspiration undiagnosed by the anesthesia care team before induction of anesthesia.

摘要

每位麻醉医生都担心在麻醉过程中发生胃内容物误吸,即使没有咳嗽或呛咳等明显体征,误吸也可能发生。无论误吸是明显的还是隐匿的,都可能导致灾难性的有害后果。因此,熟悉隐匿性误吸的危险因素至关重要。据报道,克罗恩病会延迟胃排空,使这些患者在手术期间更容易发生隐匿性误吸。麻醉医生必须认识到这种风险,并在识别过程中保持警惕,以便在术前制定具体的治疗方案。我们报告一例门诊手术患者,麻醉护理团队在麻醉诱导前未诊断出疑似隐匿性误吸。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dd5/5875231/8b0d02e23007/SJA-12-339-g001.jpg

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