Anesthetic and Obstetric Outcome in Morbidly Obese Parturients

Hood, David D.; Dewan, David M.

doi:10.1097/00000542-199312000-00011

Cited by 413 publications

(202 citation statements)

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“…Obez hastalar entübasyon başarısızlığı, aspirasyon, epidural ve spinal aneztezinin işe yaramaması gibi artan anestezik risklere sahiptirler (36) . Yapılan bir çalış-mada gösterilmiştir ki epidural anestezide katater kullanımı başarısızlığı %42 oranındadır ve entübe edilen 17 hastanın 6'sı başarısızlıkla sonuçlanmıştır (37) .…”

Section: Anestezi Endişeleriunclassified

Management of obese pregnancies

Özcan¹,

Töz²,

Özvatan³

et al. 2016

Terh

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Tepecik Eğitim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniği, İzmir ÖZDünyada üreme çağındaki kadınlarda obezite prevelansı giderek artmaktadır. Gebelikte maternal obezite anne ve fetus üzerine artmış risklerle birliktedir. Obez gebeliklerin yönetimi gebelik öncesi danışmanlıktan başlayıp, maternal obezitenin belirlenmesiyle birlikte gerekli önlemler alınarak hem anne sağlığı hem de fetal gelişiminin en iyi şekilde takip edilmesini sağlamaktır. Obez gebeliklerin yönetimi sağlıklı doğum yapmak ve uzun dönem hastaların sağlığına katkı sağlayabilen bir fırsat olabilir.Anahtar kelimeler: Maternal obezite, gebelik, gebelik komplikasyonları ABSTRACTPrevalence of obesity is gradually increasing among women in the reproductive age group all over the world. Maternal obesity during pregnancy is associated with increased risk for women and fetus. Management of obese pregnant women should begin prior to pregnancy with counselling and together with determination of maternal obesity, and ensure monitorization of both maternal and fetal health at an optimal level would decrease with necessary protection. Management of obese pregnancies can provide an opportunity for a healthy childbirth, and contribute favourable to the long-term health state of the patients.

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Section: Anestezi Endişeleriunclassified

Management of obese pregnancies

Özcan¹,

Töz²,

Özvatan³

et al. 2016

Terh

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“…1 Anesthetizing obese patients can often be challenging as they have a higher incidence of comorbidities 2 and an increased risk of a difficult airway. 3 Furthermore, obese patients are prone to intraoperative pulmonary complications 4 and acute upper airway obstruction and aspiration following tracheal extubation at the end of surgery. 5 Obese patients have a higher incidence of sleep apnea and develop hypoxia during the early postoperative period.…”

mentioning

confidence: 99%

Fast wake-up time in obese patients: Which anesthetic is best?

Katznelson

Fisher

2015

Can J Anesth/J Can Anesth

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“…These patient variations greatly affect many anaesthetic and surgical procedures, such as epidural needle insertion for which a longer Tuohy needle may be required for the morbidly obese to traverse additional adipose tissue. Anaesthetists find that successful insertion of an epidural catheter is much harder in overweight and obese parturients due to difficulties in locating the midline of the spine during palpation [1][2][3].…”

mentioning

confidence: 99%

“…(2) To accurately calculate thickness of modelled spinal ligaments, bone, fat and skin for patients of any size and shape. Novel aspects of this work include the 3D visualisation of body shape adjustable to match any patient size and shape based on clinical metrics, the anatomical model of ligaments of the back for epidural insertion which adjust in size and shape, and the collection of clinical body shape metrics into one system.…”

mentioning

confidence: 99%

Parametric model of human body shape and ligaments for patient-specific epidural simulation

Vaughan

Dubey

Wee

et al. 2014

Artificial Intelligence in Medicine

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Objective: This work builds upon the concept of matching a person's weight, height and age to their overall body shape to create an adjustable three-dimensional model. A versatile and accurate predictor of body size and shape and ligament thickness is required to improve simulation for medical procedures. A model which is adjustable for any size, shape, body mass, age or height would provide ability to simulate procedures on patients of various body compositions.Methods: Three methods are provided for estimating body circumferences and ligament thicknesses for each patient. The first method is using empirical relations from body shape and size. The second method is to load a dataset from a magnetic resonance imaging scan (MRI) or ultrasound scan containing accurate ligament measurements. The third method is a developed artificial neural network (ANN) which uses MRI dataset as a training set and improves accuracy using error back-propagation, which learns to increase accuracy as more patient data is added. The ANN is trained and tested with clinical data from 23088 patients. Results:The ANN can predict subscapular skinfold thickness within 3.54mm, waist circumference 3.92cm, thigh circumference 2.00cm, arm circumference 1.21cm, calf circumference 1.40cm, triceps skinfold thickness 3.43mm. Alternative regression analysis method gave overall slightly less accurate predictions for subscapular skinfold thickness within 3.75mm, waist circumference 3.84cm, thigh circumference 2.16cm, arm circumference 1.34cm, calf circumference 1.46cm, triceps skinfold thickness 3.89mm.for male or female patients aged 8-85. These calculations are used to display a 3D graphics model of the patient's body shape using OpenGL and adjusted by 3D mesh deformations. Conclusions:A patient-specific epidural simulator is presented using the developed body shape model, able to simulate needle insertion procedures on a 3D model of any patient size and shape.The developed ANN gave the most accurate results for body shape, size and ligament thickness.The resulting simulator offers the experience of simulating needle insertions accurately whilst allowing for variation in patient body mass, height or age.

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Anesthetic and Obstetric Outcome in Morbidly Obese Parturients

Cited by 413 publications

References 0 publications

Management of obese pregnancies

Management of obese pregnancies

Fast wake-up time in obese patients: Which anesthetic is best?

Parametric model of human body shape and ligaments for patient-specific epidural simulation

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