Morbidly obese patient with obstructive sleep apnoea for major spine surgery: An anaesthetic challenge

Redhu, Shruti; Prakash, Prabhakar Suman; Jain, Virendra; Dash, Hari H.

doi:10.4103/0019-5049.183388

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…15,26,27 Recent advances in anesthetic and surgical management, however, have made PLF an increasingly viable and safe option for morbidly obese patients, and the rate of spinal surgery in this patient population has risen in recent years. 26,[28][29][30] Current data suggests that although morbid obesity is associated with higher perioperative complications, it is not a contraindication to PLF. [14][15][16]27,31 However, there are currently no studies in the literature that examine patient characteristics and comorbidities that independently predict poor perioperative outcomes in the morbidly obese patient population.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Perioperative Complications in Morbidly Obese Patients Undergoing Elective Posterior Lumbar Fusion

Ranson

Cheung

Capua

et al. 2018

Global Spine Journal

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Study Design:Retrospective cohort study.Objectives:The prevalence of obesity-related low back pain and degenerative disc disease is on the rise. Past studies have demonstrated that obesity is associated with higher perioperative complication rates, but there remains a gap in the literature regarding additional risk factors that further predispose this already high-risk patient population to poor surgical outcomes following elective posterior lumbar fusion (PLF). The aim of the study is to identify independent risk factors for poor 30-day perioperative outcomes in morbidly obese patients undergoing elective PLF.Methods:We identified 22 909 patients in the American College of Surgeons National Surgical Quality Improvement Program database who underwent elective PLF. There were 1861 morbidly obese patients. Baseline patient demographics and medical comorbidities were collected. Univariate analysis was performed to compare perioperative complication rates between non-morbidly obese and morbidly obese patients. The 5 most common complications in the morbidly obese group were then selected for multivariate regression analysis to identify independent risk factors for poor 30-day outcomes.Results:Morbidly obese patients had a higher perioperative complication rate. The 5 most common complications were prolonged hospitalization, blood transfusion, readmission, wound complications, and reoperation. Independent risk factors for these complications were age ≥65 years, super obesity (ie, BMI > 48.6), chronic steroid use, American Society of Anesthesiology classification ≥3, poor functional status, long length of fusion ≥4 levels, and extended operative time (ie, operative time ≥318 minutes).Conclusions:Morbidly obese patients are at higher risk of perioperative complications following elective PLF. Modifiable risk factors for the most common complications are obesity and preoperative steroid use.

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Section: Introductionmentioning

confidence: 99%

Risk Factors for Perioperative Complications in Morbidly Obese Patients Undergoing Elective Posterior Lumbar Fusion

Ranson

Cheung

Capua

et al. 2018

Global Spine Journal

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Compliance with care standards and professional knowledge of operating theatre personnel before, during and after laparoscopic bariatric surgery: A study in public hospitals in Iran

Kouhestani,

Aboutalebi,

Izadan

et al. 2024

Journal of Perioperative Practice

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Introduction: By adhering to care standards, many adverse outcomes for patients, such as pressure injuries, tissue necrosis and patient falls, can be prevented. The aim of this study was to investigate the level of compliance with care standards before, during and after various types of bariatric surgeries. Materials and methods: This study was a cross-sectional descriptive study conducted in the operating theatres of selected teaching hospitals in Isfahan (Iran). The study sample consisted of all operating theatre personnel in the selected teaching hospitals who met the inclusion criteria. Compliance with care standards was measured using a researcher-developed checklist. A researcher-developed questionnaire with 43 true/false questions was used to evaluate the operating theatre personnel’s professional knowledge. The data were analysed using SPSS version 20 and descriptive and inferential statistics. Results: The mean score of adherence to care standards and the mean score of professional knowledge of operating theatre personnel regarding care of laparoscopic bariatric surgery were 78.35 ± 9.49 and 29.45 ± 6.17, respectively. There is no significant relationship between these two variables, with a two-tailed significance (Sig.) of 0.056 and a correlation coefficient (r) of 0.199. Discussion and conclusion: In general, it can be concluded that the specific knowledge of the local operating theatre personnel regarding minimally invasive laparoscopic surgery care is at an intermediate level. Requirements for training in this area were therefore successfully identified. In addition, not all operating theatre personnel adhere to the standards of care for patients undergoing laparoscopic bariatric surgery. This non-adherence could be due to insufficient training or the absence of established standards in hospitals.

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Morbidly obese patient with obstructive sleep apnoea for major spine surgery: An anaesthetic challenge

Cited by 2 publications

References 11 publications

Risk Factors for Perioperative Complications in Morbidly Obese Patients Undergoing Elective Posterior Lumbar Fusion

Risk Factors for Perioperative Complications in Morbidly Obese Patients Undergoing Elective Posterior Lumbar Fusion

Compliance with care standards and professional knowledge of operating theatre personnel before, during and after laparoscopic bariatric surgery: A study in public hospitals in Iran

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