Bronchial aspiration in patients after weight loss due to gastric banding.

Laparoscopic gastric banding is a surgical treatment of morbid obesity. There are no specific recommendations concerning anesthesia induction in patients having gastric banding. After recent experience of two bronchial aspirations during anesthetic induction in patients with gastric banding, we concluded that esophago-gastric peristalsis in these patients is altered. Such patients should consume only liquid meals the day before the operation, and we propose a rapid-sequence induction as the anesthetic technique. In patients with an expected difficult airway, an awake intubation may be considered.