Anesthesia and Recovery

Abstract

As a consequence of the obesity epidemic that has developed in the United States over the past few decades, many morbidly obese patients are presenting to the operating room for a variety of procedures, including bariatric surgery. Anesthesiologists must therefore be familiar with the physiologic changes that occur as a consequence of this disease process. Changes in cardiac and respiratory physiology require special consideration as they impact anesthetic management during the perioperative period. Strategies to optimize intraoperative management of the morbidly obese patient presenting for bariatric surgery including successful airway management, fluid management, and prevention of atelectasis are discussed. Finally, common postoperative issues are examined including renal dysfunction, respiratory insufficiency, and ICU outcomes. With planning and communication the challenges these patients present can be managed effectively by the bariatric team