Airway management concerns in patient with gastric banding procedures.

BMJ case reports

PubMedID: 24051151

Koolwijk J, Schors M, El Bouazati S, Noordergraaf GJ. Airway management concerns in patient with gastric banding procedures. BMJ Case Rep. 2013;2013.
Laparoscopic adjustable gastric band (LAGB) is considered a relatively safe and effective treatment for obesity. Even after weight loss patients with LAGB are at increased risk of pulmonary aspiration during induction of general anaesthesia, possibly due to LAGB-induced anatomical and functional changes. We present a case of aspiration in a patient with LAGB following significant weight loss and 14 h of preoperative fasting and review the literature. In the presence of LAGB we propose specific anaesthesia management at least consisting of anti-Trendelenburg positioning; avoidance of mask-ventilation; use of the local rapid sequence induction strategy with endotracheal intubation and fully awake extubation.