Technique d'induction et risque d'inhalation chez les patients ayant bénéficié d'une chirurgie amaigrissante

Abstract

Background: To our knowledge no study regarding the anesthetic risk of patients who have undergone bariatric surgery has been performed. We conducted a study including patients with gastric banding or gastroplasty who, previously underwent plastic or functional surgery to assess the risk of pulmonary aspiration in this population. Methoths: A retrospective case-control study was performed including all patients undergoing a plastic or functional surgery over 6 years period (2000 to 2005) at Rouen University Hospital. Two groups were defined: post-bariatric group included patients who had bariatric surgery (laparoscopic adjustable gastric banding or Mason's vertical gastroplasty) before underwent the plastic or orthopedic surgery, non-bariatric group were all the others patients. Data included anesthetic management were recorded in a computer database. Incidence of pulmonary aspiration was the outcome variable. Results: A total of 208 plastic and functional operations (72 cases and 136 controls) were performed. Pulmonary aspiration is significantly (p<0.005) higher in post-bariatric group (5 patients: 6.9%) than in non-bariatric group (0 patient). For this complication, all the patients had previously gastric banding. One who no received prokinetic prophylaxis, required intensive care for severe pulmonary alteration. Conclusion: The risk of perioperative pulmonary aspiration in a patient after weight loss due to bariatric surgery is very significant.ROUEN-BU Médecine-Pharmacie (765402102) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF