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Why the Obese Patient is at Risk for Perioperative Complications

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Abstract

Obesity has become a worldwide problem of epidemic proportions. Extreme obesity is associated with pathophysiologic changes in all organ systems, which in turn effect anaesthetic management. Since obese patients undergo all types of surgery, and not just weight loss operations, surgeons, anaesthesiologists and critical care physicians must be familiar with the special needs of the morbidly obese surgical patient.

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References

  1. Lemmens HJ, Brodsky JB, Bernstein DP (2005) Estimating ideal body weight—a new formula. Obes Surg 15:1082–1083

    Article  PubMed  Google Scholar 

  2. Alpert MA, Hashimi MN (1993) Obesity and the heart. Am J Med Sci 306:117–123

    Article  PubMed  CAS  Google Scholar 

  3. Pelosi P, Croci M, Ravagnan I et al (1998) The effects of body mass on lung volumes, respiratory mechanics, and gas exchange during general anesthesia. Anesth Analg 87:654–660

    Article  PubMed  CAS  Google Scholar 

  4. Brodsky JB (2002) Positioning the morbidly obese patient for anesthesia. Obes Surg 12:751–758

    Article  PubMed  Google Scholar 

  5. Jense HG, Dubin SA, Silverstein PI et al (1991) Effect of obesity on safe duration of apnea in anesthetized humans. Anesth Analg 72:89–93

    Article  PubMed  CAS  Google Scholar 

  6. Altermatt FR, Muñoz HR, Delfino AE et al (2005) Pre-oxygenation in the obese patient: effects of position on tolerance to apnoea. Br J Anaesth 95:706–709

    Article  PubMed  CAS  Google Scholar 

  7. Collins JS, Lemmens HJ, Brodsky JB (2006) Obesity and difficult intubation: where is the evidence? Anesthesiology 104:617

    Article  PubMed  Google Scholar 

  8. Brodsky JB, Lemmens HJ, Brock-Utne JG et al (2002) Morbid obesity and tracheal intubation. Anesth Analg 94:732–736

    Article  PubMed  Google Scholar 

  9. Collins JS, Lemmens HJ, Brodsky JB et al (2004) Laryngoscopy and morbid obesity: a comparison of the “sniff” and “ramped” positions. Obes Surg 14:1171–1175

    Article  PubMed  Google Scholar 

  10. Keller C, Brimacombe J, Kleinsasser A et al (2002) The Laryngeal Mask Airway ProSeal as a temporary ventilatory device in grossly and morbidly obese patients before laryngoscope-guided tracheal intubation. Anesth Analg 94:737–740

    Article  PubMed  Google Scholar 

  11. Frappier J, Guenoun T, Journois D et al (2003) Airway management usingthe intubating laryngeal mask airway for the morbidly obese patient. Anesth Analg 96:1510–1515

    Article  PubMed  Google Scholar 

  12. Bardoczky GI, Yernault JC, Houben JJ et al (1995) Large tidal volume ventilation does not improve oxygenation in morbidly obese patients during anesthesia. Anesth Analg 81:385–388

    Article  PubMed  CAS  Google Scholar 

  13. Eichenberger A, Proietti S, Wicky S et al (2002) Morbid obesity and postoperative pulmonary atelectasis: an underestimated problem. Anesth Analg 95:1788–1792

    Article  PubMed  Google Scholar 

  14. Leykin Y, Pellis T, Del Mestro E et al (2006) Anesthetic management of morbidly obese and super-morbidly obese patients undergoing bariatric operations: hospital course and outcomes. Obes Surg 16:1563–1569

    Article  PubMed  Google Scholar 

  15. Mortimore IL, Marshall I, Wraith PK (1998) Neck and total body fat deposition in nonobese and obese patients with sleep apnea compared with that in control subjects. Am J Resp Crit Care Med 157:280–283

    PubMed  CAS  Google Scholar 

  16. Vaughan RW, Bauer S, Wise L (1975) Volume and pH of gastric juice in obese patients. Anesthesiology 43:686–689

    Article  PubMed  CAS  Google Scholar 

  17. Harter RL, Kelly WB, Kramer MG et al (1998) A comparison of the volume and pH of gastric contents of obese and lean surgical patients. Anesth Analg 86:147–152

    Article  PubMed  CAS  Google Scholar 

  18. Eriksson S, Backman L, Ljungstrom KG (1997) The incidence of clinical postoperative thrombosis after gastric surgery for obesity during 16 years. Obes Surg 7:332–335

    Article  PubMed  CAS  Google Scholar 

  19. Lemmens HJ, Bernstein DP, Brodsky JB (2006) Estimating blood volume in obese and morbidly obese patients. Obes Surg 16:773–776

    Article  PubMed  Google Scholar 

  20. de Menezes Ettinger JE, dos Santos Filho PV, Azaro E et al (2005) Prevention of rhabdomyolysis in bariatric surgery. Obes Surg 15:874–879

    Article  PubMed  Google Scholar 

  21. Mognol P, Vignes S, Chosidow D et al (2004) Rhabdomyolysis after laparoscopic bariatric surgery. Obes Surg 14:91–94

    Article  PubMed  Google Scholar 

  22. Kranke P, Apefel CC, Papenfuss T et al (2001) An increased body mass index is no risk factor for postoperative nausea and vomiting. Acta Anaesthesiol Scand 45:160–166

    Article  PubMed  CAS  Google Scholar 

  23. Schuster R, Alami RS, Curet MJ et al (2006) Intra-operative fluid volume influences postoperative nausea and vomiting after laparoscopic gastric bypass surgery. Obes Surg 16: 848–851

    Article  PubMed  Google Scholar 

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© 2008 Springer-Verlag Italia

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Brodsky, J.B. (2008). Why the Obese Patient is at Risk for Perioperative Complications. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-0773-4_29

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  • DOI: https://doi.org/10.1007/978-88-470-0773-4_29

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0772-7

  • Online ISBN: 978-88-470-0773-4

  • eBook Packages: MedicineMedicine (R0)

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