对于接受塞马格卢提德和延迟胃空化的患者来说,麻醉的考虑因素
Erina Fujino1, Kathryn W Cobb1, Jay Schoenherr1
1Anesthesiology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, USA.
Cureus
|August 21, 2023
概括
用于治疗2型糖尿病和肥胖症的塞马格卢提德可以导致胃排空延迟. 这导致患者由于食物残留而必须取消EGD,突出了麻醉期间的风险.
科学领域:
- 麻醉学 麻醉学
- 内分泌学 在内分泌学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 塞马格卢提德是治疗2型糖尿病和肥胖症的GLP1-RA.
- 延迟胃空气是西马格卢提德的已知副作用之一.
- 标准的手术前禁食指南可能对接受塞马格卢提德治疗的患者来说不足.
研究的目的:
- 为了突出服用西马格卢提德的患者进行需要禁食的手术时肺吸气的风险.
- 强调需要更新的手术前指导方针,用于患者在塞马格卢提德.
- 告知麻醉科医生关于与西马格卢提德使用相关的潜在手术内风险.
主要方法:
- 一个患者的病例报告,他接受了EGD,接受了semaglutide.
- 对手术前禁食指南 (ASA) 的审查.
- 观察手术内发现 (胃残留) 的观察.
主要成果:
- 尽管遵守ASA禁食指南,但该患者有显著的胃食物残留物.
- 为了防止肺吸气,食管胃管腺镜检查 (EGD) 被中止.
- 这一案例凸显了塞马格卢提德对胃排空时间的影响.
结论:
- 麻醉科医生必须意识到,在服用塞马格卢提德的患者中,胃空气的延迟.
- 当前的禁食指南可能无法充分缓解这些患者的吸血风险.
- 在麻醉下进行手术之前,需要使用其他方法来确认胃空.
相关概念视频
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
115
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
115
Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
199
Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
199
Drugs Affecting GI Tract Motility: Serotonin Receptor Agonists
303
Serotonin, a crucial neurotransmitter synthesized by enterochromaffin cells, plays a cardinal role in regulating gastrointestinal (GI) motility. With over 90% of the body's total serotonin in the GI tract, its influence on digestive processes is profound. Serotonin is swiftly released upon various stimuli, such as food boluses or certain drugs, triggering intrinsic sensory neurons in the myenteric plexus and extrinsic vagal and spinal sensory neurons. This leads to the activation of the...
303
Glucagon-like Receptor Agonists
358
Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by...
358
Gastric Emptying
919
Gastric emptying occurs when the stomach gradually releases chyme into the duodenum. When the stomach is distended, it triggers the release of gastrin, a hormone that promotes gastric acid secretion to aid in digestion. Additionally, stomach distension contributes to peristaltic waves that propel gastric contents toward the pyloric region. The gastroenteric reflex, on the other hand, primarily stimulates peristalsis in the intestines, facilitating the movement of contents further along the...
919
Oral Hypoglycemic Agents: Glinides
184
Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively...
184

