减肥药物在麻醉状态下可能有并发症风险
Weight Loss Drugs May Risk Complications under Anesthesia
刘立军 供稿
TRANSCRIPT
Doctors who practice anesthesiology in the United States and Canada are expressing concern about patients who take popular weight loss drugs leading up to surgery. Anesthesiologists work together with surgeons to make sure their patients are asleep, or sedated, before medical procedures. More and more people are taking the weight loss drugs Ozempic and Wegovy. Anesthesiologists say they are having trouble deciding when surgeries should take place. That is because the weight loss drugs cause people to hold food in their stomachs longer than usual. People who still have food in their stomachs when they are put to sleep before surgery risk a complication known as a pulmonary aspiration. That is the term for when someone breathes some of their stomach contents into their lungs. In extreme cases, the food particles can cause infection or even death.
Most patients are told to not eat for about eight hours before surgery. However, the doctors say those guidelines may need to be changed for patients who are using the weight loss drugs. Ion Hobai is an anesthesiologist at Massachusetts General Hospital in Boston. He said everyone who takes the drugs should know about "such a serious sort of potential complication." Komodo Health is a technology company that works in healthcare. According to its research, nearly 6 million prescriptions for the weight loss drugs were written in the first five months of 2023. In June, the American Society of Anesthesiologists said patients should not take daily weight loss medications on the day of surgery. It also advised that patients should not get their weekly weight loss injection for a week before any sedation procedures. Dr. Michael Champeau is the head of the organization. He said the recommendation is based on experiences from anesthesiologists around the United States.
A group of anesthesiologists, including Hobai, said they would recommend even more time off from the drugs before surgery. In the Canadian Journal of Anesthesia, they suggested about three weeks. Dr. Philip Jones is an anesthesiologist at the Mayo Clinic in Minnesota. After three weeks, he said, the drug should no longer be affecting the stomach. At that point, he said, "everything should go back to normal." Hobai said he is finishing a study of 200 patients who were using drugs such as Ozempic and Wegovy before surgery. He said his results are similar to a smaller study in Brazil that found 25 percent of patients still had food in their stomachs 10 days after stopping the drug. Because of this information, the American Society of Anesthesiologists said doctors who are unsure of their patients' stomach contents should work differently. They say doctors should work as they would if they knew the patient's stomach was full. Aspiration only happens one time out of every 2,000 to 3,000 operations that require sedation. But when it does happen, the patients develop a lung injury half the time. That is why the doctors are concerned. One of Hobai's patients who had been taking Wegovy developed a problem that required serious care. He had not eaten for 18 hours before surgery. In another case, a woman taking a small amount of Ozempic did not eat for 10 hours before surgery. She was in the middle of a procedure that had to be stopped because doctors saw food in her stomach.
Dr. Elisa Lund is an anesthesiologist at the University of North Carolina in Chapel Hill. She said many doctors have similar stories, as the weight loss drugs have become more common. "It has exponentially increased," she said. Novo Nordisk is the drug company that makes Wegovy and Ozempic. The company said there was nothing in its testing that showed the drug would lead to aspiration. However, the drug-maker did say the medications can cause the stomach to empty more slowly. Hobai said he is also concerned about patients going off their medications for too long. For example, the drugs are used to control the blood sugar level of patients with diabetes. If they stop taking them before surgery, they may face a different kind of health problem. He said patients who are using the drugs should tell their doctors about them and discuss the risks of having surgery. "If you're taking this drug and you need an operation, you will need to have some extra precautions," he said.
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VOCABULARY
1. anesthesiology n. 麻醉学
2. sedate v. to give sb. drugs in order to make them calm and / or to make them sleep 给……服镇静剂。例如：Most of the patients are heavily sedated. 多数病人服了大剂量镇静药。
3. pulmonary adj. connected with the lungs 肺的；肺部的；与肺有关的
4. sedation n. the act of giving sb. drugs in order to make them calm or to make them sleep; the state that results from this 药物镇静；镇静状态。例如：The victim's wife was last night being kept under sedation in the local hospital. 昨晚，受害人的妻子在当地医院接受镇静治疗。
5. exponentially adv. 以指数方式
QUESTIONS
Listen to the news and choose the best answer to each question you hear.
1. What potential complication can weight loss drugs lead to during surgeries?
A. Cardiac arrest.
B. Pulmonary aspiration.
C. Kidney failure.
D. Blood clotting.
2. What is the current guideline for patients about eating before surgery?
A. Do not eat for about eight hours before surgery.
B. Eat a small meal two hours before surgery.
C. Drink plenty of water up until the surgery.
D. Fast for 24 hours prior to surgery.
3. Who suggested that patients should stop taking the weight loss drugs about three weeks before the surgery?
A. Dr. Ion Hobai.
B. Dr. Michael Champeau.
C. Komodo Health.
D. Dr. Philip Jones.
4. What percentage of patients in the Brazil study still had food in their stomachs 10 days after stopping the drug?
A. 15%.
B. 25%.
C. 35%.
D. 45%.
5. Why does Dr. Ion Hobai worry about patients going off their medications for too long?
A. Because it could lead to withdrawal symptoms.
B. Because the drugs are also used to control the blood sugar level of patients with diabetes.
C. Because it might cause an increase in appetite and consequent weight gain.
D. Because it might cause a rebound effect on the patients' metabolism.
KEY
1. What potential complication can weight loss drugs lead to during surgeries?
A. Cardiac arrest.
B. Pulmonary aspiration.
C. Kidney failure.
D. Blood clotting.
【答案】B
【解析】细节题。命题出处在文章的第一段，提到了由于使用减肥药物导致食物在胃中停留的时间比正常人要长，进而在手术麻醉时可能导致肺部吸入症（pulmonary aspiration）这一潜在的并发症。
2. What is the current guideline for patients about eating before surgery?
A. Do not eat for about eight hours before surgery.
B. Eat a small meal two hours before surgery.
C. Drink plenty of water up until the surgery.
D. Fast for 24 hours prior to surgery.
【答案】A
【解析】细节题。命题出处位于文章的第二段，医生通常建议大多数患者在手术前约八个小时内不要进食。
3. Who suggested that patients should stop taking the weight loss drugs about three weeks before the surgery?
A. Dr. Ion Hobai.
B. Dr. Michael Champeau.
C. Komodo Health.
D. Dr. Philip Jones.
【答案】D
【解析】细节题。命题出处位于文章的中段，Dr. Philip Jones 提出了患者应该在手术前约三周停止服用这些减肥药物的建议。
4. What percentage of patients in the Brazil study still had food in their stomachs 10 days after stopping the drug?
A. 15%.
B. 25%.
C. 35%.
D. 45%.
【答案】B
【解析】细节题。命题出处位于文章的后半部分，其中一项在巴西进行的小规模研究发现，在停药10天后，仍有25%的患者胃里有食物。
5. Why does Dr. Ion Hobai worry about patients going off their medications for too long?
A. Because it could lead to withdrawal symptoms.
B. Because the drugs are also used to control the blood sugar level of patients with diabetes.
C. Because it might cause an increase in appetite and consequent weight gain.
D. Because it might cause a rebound effect on the patients' metabolism.
【答案】B
【解析】推理题。命题出处位于文章的最后一段，Hobai医生对患者长期停药感到担忧，因为这些药物也被用来控制糖尿病患者的血糖，如果他们在手术前停药，可能会面临另一种健康问题。
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