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司美格鲁肽、胃排空延迟和术中误吸:病例报告。

Semaglutide, delayed gastric emptying, and intraoperative pulmonary aspiration: a case report.

机构信息

The Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA.

The Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, 55 Fruit Str., GRB 444, Boston, MA, 02114, USA.

出版信息

Can J Anaesth. 2023 Aug;70(8):1394-1396. doi: 10.1007/s12630-023-02440-3. Epub 2023 Mar 28.

Abstract

PURPOSE

We report a case in which the use of semaglutide for weight loss was associated with delayed gastric emptying and intraoperative pulmonary aspiration of gastric contents.

CLINICAL FEATURES

A 42-yr-old patient with Barrett's esophagus underwent repeat upper gastrointestinal endoscopy and ablation of dysplastic mucosa. Two months earlier, the patient had started weekly injections of semaglutide for weight loss. Despite having fasted for 18 hr, and differing from the findings of prior procedures, endoscopy revealed substantial gastric content, which was suctioned before endotracheal intubation. Food remains were removed from the trachea and bronchi using bronchoscopy. The patient was extubated four hours later and remained asymptomatic.

CONCLUSION

Patients using semaglutide and other glucagon-like peptide 1 agonists for weight management may require specific precautions during induction of anesthesia to prevent pulmonary aspiration of gastric contents.

摘要

目的

我们报告了一例使用司美格鲁肽减肥与胃排空延迟和术中胃内容物吸入相关的病例。

临床特征

一名 42 岁的巴雷特食管患者接受了重复上消化道内镜检查和异型增生黏膜消融。两个月前,患者开始每周注射司美格鲁肽减肥。尽管患者已经禁食 18 小时,但与之前手术的发现不同,内镜检查显示胃内有大量内容物,在气管插管前进行了抽吸。使用支气管镜从气管和支气管中取出食物残渣。四小时后患者拔管,无任何症状。

结论

使用司美格鲁肽和其他胰高血糖素样肽 1 激动剂进行体重管理的患者,在接受麻醉诱导时可能需要特殊的预防措施,以防止胃内容物吸入。

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