Anesthetic Management of the Obese Surgical Patient by Jay B. Brodsky

By Jay B. Brodsky

The worldwide weight problems epidemic is becoming in severity, affecting humans of all ages and costing healthcare prone hundreds of thousands of bucks each year. on a daily basis, anesthesiologists are awarded with overweight and morbidly overweight sufferers present process all kinds of surgery; the administration of those sufferers differs considerably from that of ordinary weight sufferers present process a similar strategy. Anesthetic administration of the overweight Surgical sufferer discusses those particular administration matters inside every one surgical uniqueness region. preliminary chapters describe pre-operative evaluate and pharmacology; those are via distinct chapters at the anesthetic administration of a wide selection of surgeries, from joint substitute to open middle surgical procedure. crucial interpreting for anesthesiologists and nurse anesthetists all over the world, Anesthetic administration of the overweight Surgical sufferer and its spouse paintings through an analogous authors, Morbid weight problems: Peri-operative administration, permit either trainees and practised pros to regulate this advanced sufferer staff successfully.

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Currently a low molecular weight heparin is the agent of choice for DVT prophylaxis. [3] 26 Section 1: General considerations Prophylaxis for aspiration Obese patients have historically been thought of as having a potentially full stomach and to be at greater risk for pulmonary acid aspiration on induction of general anesthesia than normal-weight patients. 5) in obese and MO patients. These longheld beliefs were first challenged over a decade ago. [5] Obesity is actually associated with a significantly decreased risk of HVLP gastric contents among surgical patients with no history of gastro-esophageal pathology after a normal interval of pre-operative fasting.

Tung A. Anaesthetic considerations with the metabolic syndrome. Br J Anaesth 2010; 105 Suppl 1: i24–i33. 2. Afolabi BA, Novaro GM, Szomstein S, Rosenthal RJ, Asher CR. Cardiovascular complications of obesity surgery in patients with increased preoperative cardiac risk. Surg Obes Relat Dis 2009; 5: 653–656. 3. Kalfarentzos F, Stavropoulou F, Yarmenitis S et al. Prophylaxis of venous thromboembolism using two different doses of low-molecular-weight heparin (nadroparin) in bariatric surgery: a prospective randomized trial.

The conclusion of this study and others is that obesity is not a risk factor for development of post-operative complications. Even so, obese patients do have unique management needs. In order to avoid post-operative complications, the anesthesiologist must be familiar with the special problems that can occur with these patients. Position Patient position, as always, is extremely important. A head-elevated or semi-recumbent position maximizes oxygenation in the post-operative period. Therefore, if hemodynamically stable the MO patient should have their airway extubated while their upper body is elevated 30–45 and then be transferred and recovered in the post-operative care unit (PACU) in that same position.

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