Resume. Resuscitation of the obese patient presents a challenge for even the most skilled physician. Changes in anatomy, metabolic, cardiopulmonary reserve, ventilation, circulation, and pharmacokinetics require special consideration. This article focuses on critical components in the resuscitation of the obese patient, namely circulatory resuscitation, defibrillation, approach to the obese airway and mechanical ventilation, pharmacotherapy of cardiovascular drugs.
Materials and methods: Electronic databases of Scopus and PubMed were searched using keyword searches
Conclusions. Obesity causes important anatomical and physiological changes that affect resuscitation measures. Healthcare professionals should take into account the specifics of cardiopulmonary resuscitation in patients with morbid obesity to increase the effectiveness of resuscitation in this group of patients
The aim: To assess the effectiveness and feasibility of laparoscopically assisted TAP block utilization in the system of multimodal analgesia by comparing the severity of pain and associated postoperative recovery indicators in obese patients after laparoscopic sleeve gastrectomy
Materials and methods: The retrospective study included 39 patients, who underwent metabolic surgery from 2013-2022. All patients were divided into 2 groups depending on the chosen perioperative analgesia protocol. Group 1 included 19 patients who prior to skin incision a local infiltration of the trocar puncture areas of the abdominal wall. Group 2 included 20 patients, whom in addition to the above-described anaesthesia procedure after completion of the main stage of surgery, a laparoscopically assisted bilateral subcostal TAP block was additionally performed
Results: The need to use opioid analgesics in the rescue analgesia mode arose in 17.6% (3/17) of patients of the first group, and 5% (1/20) of patients in the second group Average duration of postoperative hospitalization in group 1 was 7.2±1.1 days, and in group 2 it was 6.2±1.4 days (P <0.05).
Conclusions: Subcostal TAP block in obese patients is a safe and effective method of regional anaesthesia. Further study of this option of regional anaesthesia is required in order to be able to form clearer recommendations for its routine use in clinical practice.
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