A review on the anesthetic management of obese patients undergoing surgery

Abstract

There has been an observed increase in theprevalence of obesity over the past few decades. The prevalence of anesthesiology related complications is also observed more frequently in obese patients as compared to patients that are not obese. Due to the increased complications that accompany obesity, obese patients are now more often requiring surgical interventions. Therefore, it is important that anesthesiologists be aware of this development and is equipped to manage these patients effectively and appropriately. As a result, this review highlights the effective management of obese patients undergoing surgery focusing on the preoperative, perioperative and postoperative care of these patients.

Post-traumatic Acetabulum Open Reduction Internal Fixation in a Patient with a BMI of 77

“…Interdisciplinary collaboration is important when treating obese patients. Special circumstances including increased tissue surrounding the oropharynx and difficulty with neck extension can make intubation more challenging, further necessitating communication with the anesthesia team 6,16 . Patients who are obese are also at increased risk of cardiovascular comorbidity, increased work of breathing, and reduced functional residual capacity [6][7][8]19,20 .…”

“…Special circumstances including increased tissue surrounding the oropharynx and difficulty with neck extension can make intubation more challenging, further necessitating communication with the anesthesia team 6,16 . Patients who are obese are also at increased risk of cardiovascular comorbidity, increased work of breathing, and reduced functional residual capacity [6][7][8]19,20 . Proper padding and preoperative antibiotics can minimize the risk of neurapraxia and infection, respectively 11,12 .…”

“…2). Normally, this injury pattern would undergo conscious sedation in the emergency department for skeletal traction and attempted closed reduction; however, the risks of manual airway maintenance were too high secondary to his BMI of 77 6 , so he was initially managed nonoperatively and transferred to the senior author for discussion of operative treatment. The goal of surgery was safe restoration of the femoral head within the acetabulum.…”

Morbid Obesity and Diabetes Increase the Risk of Reoperation following Microvascular Decompression: A National Surgical Quality Improvement Program Analysis of 1,303 Patients

“…The critical periods between anesthesia induction and waking are especially tenuous for patients with obesity who are at increased risk of perioperative respiratory failure, aspiration, myocardial infarction, infection, and anesthetic failure. 28,30 Alternative treatment strategies may be considered for patients with morbid obesity and/or diabetes. Stereotactic radiosurgery (SRS) is a recognized alternative and effective means for providing relief for patients with TN.…”

Risk Factors of Postoperative Nausea and Vomiting on General Anesthesia in RSUD Abdul Wahab Sjahranie Samarinda

“…Penelitian Eberhart et al (1998) di Jerman memberi hasil yang sebaliknya yaitu IMT obesitas lebih berisiko mengalami mual dan muntah pascaoperasi (Kim et al, 2020). Pasien dengan IMT obesitas dikaitkan dengan reservoir lemak yang lebih banyak, sehingga paparan dan eliminasi dari anestesi volatil, opioid, dan beberapa benzodiazepin menjadi lebih panjang (Seyni-Boureima et al, 2022). Penggunaan fentanil di RS AW Syahranie yang bersifat sangat larut lemak menyebabkan peningkatan volume distribusi pada pasien obesitas (Vaughns et al, 2017), sehingga berhubungan dengan peningkatan risiko mual dan muntah pascaoperasi (Mauermann et al, 2019).…”