#DrKKAnswers:
1. Patients with significant comorbidities, pulmonary surgery, or postoperative anemia are at greater risk during flight and should be carefully assessed.
2. General anesthesia is not usually a concern, but postspinal headache has been reported seven days after a spinal anesthetic, possibly because changes in cabin pressure induced a dural leak.
3. Invasive procedures introduce air into isolated body cavities that could expand at altitude in a pressurized cabin and cause barotrauma.
4. Patients should postpone air travel until at least 10 to 14 days after most surgical procedures. This delay should provide enough time for air in the intrathoracic, intraabdominal, or other cavities to be resorbed, and reduces the risk for barotrauma.
5. Laparoscopic abdominal procedures are less often associated with ileus than open procedures. The carbon dioxide introduced into the peritoneum during the procedure rapidly diffuses into the tissues, and patients can usually fly the next day if they do not have bloating.
6. Patients who have undergone a colonoscopy with polypectomy should wait at least 24 hours before flying because of the large amount of gas often present in the colon and the risk of bleeding or perforation at the polypectomy site.
7. Patients with colostomies are not at increased risk inflight, but increased fecal output resulting from intestinal distention may occur. A larger bag or frequent changes may be necessary.
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