Obesity Surgery

, Volume 10, Issue 4, pp 353–360 | Cite as

Total Intravenous Anesthesia with Midazolam, Remifentanil, Propofol and Cisatracurium in Morbid Obesity

  • Adrián Osvaldo Alvarez
  • Antonio Cascardo
  • Silvio Albarracin Menendez
  • Juan José Capria
  • Rafael Alvarez Cordero
Article

Background: According to physical impairments of massive obesity, cardiac, respiratory and gastrointestinal physiology must be considered as much as pharmacokinetic behavior. Anesthetic management of morbidly obese patients has to be carefully planned, in order to minimize the increased risks of aspirative pneumonitis, hemodynamic instability and delay in recovery.The ideal anesthesia should provide a smooth and quick induction, allowing rapid airway control, prominent hemodynamic stability, and rapid emergence from anesthesia.To approach these ideal conditions,aTotal Intravenous Anesthesia (TIVA) with midazolam, remifentanil, propofol and cisatracurium was designed and analyzed. Methods: 10 consenting morbidly obese patients scheduled for elective Laparoscopic Adjustable Gastric Banding participated in the study.TIVA with midazolam, remifentanil, propofol and cisatracurium was used in all cases.Time to loss of consciousness, tracheal intubation, perianesthetic physiological parameters and complications, incidence of awareness with recall, recovery times, postoperative analgesia and costs of drugs were evaluated. Results:The analyzed data showed adequate time and physiological conditions for induction and tracheal intubation, stable maintenance with easy handling of deepness, low incidence of perianesthetic complications, excellent recovery performance and institutional efficiency. Conclusions: TIVA with midazolam, remifentanil, propofol and cisatracurium was found to be effective, secure, predictable and economic for the anesthetic management of morbidly obese patients.

ANESTHESIA BARIATRIC SURGERY TIVA REMIFENTANIL MIDAZOLAM CISATRACURIUM ROCURONIUM PROPOFOL MORBID OBESITY CO-INDUCTION 

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Copyright information

© Springer 2000

Authors and Affiliations

  • Adrián Osvaldo Alvarez
    • Antonio Cascardo
      • Silvio Albarracin Menendez
        • Juan José Capria
          • Rafael Alvarez Cordero

            There are no affiliations available

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