Best Practice Recommendations for Anesthetic Perioperative Care and Pain Management in Weight Loss Surgery

Schumann, Roman; Jones, Stephanie B.; Ortiz, Vilma E.; Connor, Kathleen A.; Pulai, Istvan; Ozawa, Edwin T.; Harvey, Alan M.; Carr, Daniel B.

doi:10.1038/oby.2005.35

Cited by 83 publications

(44 citation statements)

References 65 publications

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“…The team is responsible for the development, implementation, and evaluation of a multidisciplinary treatment program (13) that includes comprehensive medical screening, appropriate preoperative preparation and perioperative and postoperative care, collaboration among providers from diverse disciplines [e.g., anesthesiology (134), pulmonary medicine, cardiology, gastroenterology, and psychology (135)], and both preoperative and long-term nutrition education/counseling. Communication and understanding of treatment goals by all team members are required for success.…”

Section: Discussionmentioning

confidence: 99%

Criteria for Patient Selection and Multidisciplinary Evaluation and Treatment of the Weight Loss Surgery Patient

et al. 2005

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Criteria for patient selection and multidisciplinary evaluation and treatment of the weight loss surgery patient. Obes Res. 2005;13:234 -243. Objective: To provide evidence-based guidelines for patient selection and to recommend the medical and nutritional aspects of multidisciplinary care required to minimize perioperative and postoperative risks in patients with severe obesity who undergo weight loss surgery (WLS). Research Methods and Procedures: Members of the Multidisciplinary Care Task Group conducted searches of MEDLINE and PubMed for articles related to WLS in general and medical and nutritional care in particular. Pertinent abstracts and literature were reviewed for references. Multiple searches were carried out for various aspects of multidisciplinary care published between 1980 and 2004. A total of 3000 abstracts were identified; 242 were reviewed in detail. Results: We recommended multidisciplinary screening of WLS patients to ensure appropriate selection; preoperative assessment for cardiovascular, pulmonary, gastrointestinal, endocrine, and other obesity-related diseases associated with increased risk for complications or mortality; preoperative weight loss and cessation of smoking; perioperative prophylaxis for deep vein thrombosis and pulmonary embolism (PE); preoperative and postoperative education and counseling by a registered dietitian; and a well-defined postsurgical diet progression. Discussion: Obesity-related diseases are often undiagnosed before WLS, putting patients at increased risk for complications and/or early mortality. Multidisciplinary assessment and care to minimize short-and long-term risks include: comprehensive medical screening; appropriate pre-, peri-, and postoperative preparation; collaboration with multiple patient care disciplines (e.g., anesthesiology, pulmonary medicine, cardiology, and psychology); and long-term nutrition education/counseling.

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Section: Discussionmentioning

confidence: 99%

Criteria for Patient Selection and Multidisciplinary Evaluation and Treatment of the Weight Loss Surgery Patient

et al. 2005

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“…In a recent report, recommendations considering preoperative management of patients about to undergo weight loss surgery are given (118). Several aspects deserve special attention.…”

Section: Six Weeks Postoperativementioning

confidence: 99%

Surgical treatment of obesity

Bult¹,

Dalen²,

Müller³

2008

European Journal of Endocrinology

240

141

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More than half of the European population are overweight (body mass index (BMI) O25 and !30 kg/m 2 ) and up to 30% are obese (BMIR30 kg/m 2 ). Being overweight and obesity are becoming endemic, particularly because of increasing nourishment and a decrease in physical exercise. Insulin resistance, type 2 diabetes, dyslipidemia, hypertension, cholelithiasis, certain forms of cancer, steatosis hepatis, gastroesophageal reflux, obstructive sleep apnea, degenerative joint disease, gout, lower back pain, and polycystic ovary syndrome are all associated with overweight and obesity. The endemic extent of overweight and obesity with its associated comorbidities has led to the development of therapies aimed at weight loss. The long-term effects of diet, exercise, and medical therapy on weight are relatively poor. With respect to durable weight reduction, bariatric surgery is the most effective long-term treatment for obesity with the greatest chances for amelioration and even resolution of obesity-associated complications. Recent evidence shows that bariatric surgery for severe obesity is associated with decreased overall mortality. However, serious complications can occur and therefore a careful selection of patients is of utmost importance. Bariatric surgery should at least be considered for all patients with a BMI of more than 40 kg/m 2 and for those with a BMI of more than 35 kg/m 2 with concomitant obesity-related conditions after failure of conventional treatment. The importance of weight loss and results of conventional treatment will be discussed first. Currently used operative treatments for obesity and their effectiveness and complications are described. Proposed criteria for bariatric surgery are given. Also, some attention is devoted to more basic insights that bariatric surgery has provided. Finally we deal with unsolved questions and future directions for research. European Journal of Endocrinology 158 135-145

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“…10 It is reasonable to suggest that anaesthesia for bariatric surgery should be performed by anaesthesiologists…”

Section: Resultsmentioning

confidence: 99%

Anaesthesia for bariatric surgery

Kluyts

2011

Southern African Journal of Anaesthesia and Analgesia

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Best Practice Recommendations for Anesthetic Perioperative Care and Pain Management in Weight Loss Surgery

Cited by 83 publications

References 65 publications

Criteria for Patient Selection and Multidisciplinary Evaluation and Treatment of the Weight Loss Surgery Patient

Criteria for Patient Selection and Multidisciplinary Evaluation and Treatment of the Weight Loss Surgery Patient

Surgical treatment of obesity

Anaesthesia for bariatric surgery

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