Review
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Year 2020, , 112 - 121, 20.05.2020

Sezgin Bilgin , Yasemin Burcu Üstün , Ersin Köksal

https://doi.org/10.7197/cmj.vi.615546

Abstract

References

  • 1- Taşkın M, Zengin SÜ, Taşkın HE, Bariyatrik ve Metabolik Cerrahinin Tarihçesi, Turkiye Klinikleri J Gen Surg-Special Topics. 2015;8(3):1-5.
  • 2- Buchwald H. The Evolution of Metabolic/Bariatric Surgery. Obes Surg 2014; 24: 1126-1135.
  • 3- Nightingale CE, Margarson MP, Shearer E, et al. Association of Anaesthetists of Great Britain; Ireland Society for Obesity and Bariatric Anaesthesia. Peri-operative management of the obese surgical patient 2015 Jul;70:859-76.
  • 4- Frey WC &Pilcher J. Obstructivesleep-related breathing disorders in patients evaluated for bariatric surgery. Obesity Surgery 2003; 13: 676–683.
  • 5- Hallowell PT, Stellato TA, Schuster M et al. Potentially life-threatening sleep apnea is unrecognized without aggressive evaluation. AmericanJournal of Surgery2007; 193: 364–367.
  • 6- ASA guidlines OSA Practice Guidelines for the Perioperative Management of Patients with Obstructive Sleep Apnea: An Updated Report by the American Society of Anesthesiologists Task Force on Perioperative Management of Patients with Obstructive Sleep Apnea. Anesthesiology 2014;120(2):268-286.
  • 7- Acar HV, Kaya A, Yucel F, et al. Obstruktif Uyku Apnesi Tarama Testi Olarak Kullanılan STOP-Bang Testinin Turk Populasyonunda Gecerliliğinin Saptanması Turk J Anaesth Reanim 2013; 41: 115-20.
  • 8- Juvin P, Lavaut E, Dupont H, et al. Difficult tracheal intubation is more common in obese than in lean patients. Anesth Analg. 2003;97(2):595–600.
  • 9- Ezri T, MedalionB,Weisenberg M, et al. Increased Body mass index per se is not a predictor of difficult laryngoscopy. Can J Anaesth. 2003;50(2):179–83.
  • 10- Kristensen MS. Airway management and morbid obesity.Eur J Anaesthesiol 2010;27:923–927.
  • 11- Yao, F.-S.F.. (2012). Yao & Artusio's anesthesiology: Problem-oriented patient management: Seventh edition.
  • 12- Blokhin IO, Lentz SR. Mechanisms of thrombosis in obesity. Current Opinion in Hematology 2013; 20: 437–44.
  • 13- Parkin L, Sweetland S, Balkwill A, Green J, Reeves G, Beral V. Body massindex, surgery, and risk of venous thromboembolism in middle-aged women: a cohort study. Circulation 2012; 125: 1897–904.
  • 14- Magee CJ, Barry J, Javed S, Macadam R, Kerrigan D. Extended thromboprophylaxis reduces incidence of postoperative venous thromboembolism in laparoscopic bariatric surgery. Surgery for Obesity and Related Diseases 2010; 6:322–5.
  • 15- Schumann R, Anaesthesia for bariatric surgery. Best Practice&Research Clinical Anaesthesiology 2011; 25: 83–93.
  • 16- Hanley MJ, Abernethy DR, Greenblatt DJ. Effect of obesity on the pharmacokinetics of drugs in humans. Clinical Pharmacokinetics 2010; 49: 71–87.
  • 17- De Baerdemaeker LEC, Mortier EP, Struys MMRF. Pharmacokinetics in obesepatients.ContinuingEducation in Anaesthesia, Critical Care&Pain 2004: 4; 152-155.
  • 18- Soleimanpour H, Safari S, Sanaie S, Nazari M, Alavian SM. Anesthetic Considerations in Patients Undergoing Bariatric Surgery: A Review Article. Anesth Pain Med. 2017 Jul 11;7(4):e57568.
  • 19- Ingrande J, Lemmens HJ. Dose adjustment of anesthetics in the morbidly obese. Br J Anaesth. 2010;105 Suppl 1:i16-23. 20- Leykin Y, Miotto L, Pellis T. Pharmacokinetic considerations in the obese. Best Practice&Research Clinical Anaesthesiology 2011; 25: 27–36.
  • 21- Fernandez-Bustamante A, Hashimoto S, Serpa Neto A, et al. Perioperative lung protective ventilation in obese patients. BMCAnesthesiol. 2015;15:56.
  • 22- Pösö T, Kesek D, Aroch R, Winsö O. Morbid Obesity and Optimization of Preoperative Fluid Therapy. Obesity Surgery 2013; 23: 1799–1805.
  • 23- Pösö T, Kesek D, Aroch R, WinsöO. Rapid weight loss is associated with perioperative hypovolemia in morbidly obese patients.ObesSurg. 2013; 23: 306-13.
  • 24- PösöT, WinsöO, ArochR, KesekD. Perioperative fluid guidance with transthoracic echocardiography and pulse contour device in morbidly obese patients. Obes Surg. 2014; 24:2117-25.
  • 25- Brodsky JB, Mariano ER. Regional anaesthesia in the obese patient: Lost landmarks and evolving ultrasound guidance. Best Pract Res Clin Anaesthesiol. 2011; 25: 61–72.
  • 26- Huerta S, DeShields S, Shpiner R, et al. Safety and efficacy of postoperative continuous positive airway pressure to prevent pulmonary complications after Roux-en-Y gastric bypass. Journal of Gastrointestinal Surgery 2002; 6: 354–358.
  • 27- Ramirez A, Lalor PF, Szomstein S, Rosenthal J. Continuous positive airway pressure in the immediate postoperative period after laparoscopic Roux-en-Y gastric bypass: is it safe? Surgery for Obesity and Related Diseases2009; 5: 544–546.
  • 28-Thorell A, MacCormick AD, Awad S, et al. Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations. World J Surg 2016; 40:2065–2083.
  • 29-Porhomayon J, Leissner KB, El-Solh AA, Nader ND. Strategies in Postoperative Analgesia in the Obese Obstructive Sleep Apnea Patient. Clin J Pain2013;29:998–1005.
  • 30-Schug SA, Raymann A. Postoperative pain management of the obese patient. Best Pract Res Clin Anaesthesiol. 2011; 25.73-81.
  • 31-Govindarajan R, Ghosh B, Sathyamoorthy MK, et al. Efficacy of ketorolac in lieu of narcotics in the operative management of laparoscopic surgery for morbid obesity. Surgery for Obesity and Related Diseases 2005; 1: 530–535.
  • 32- Kamelgard J. Combined preemptive and preventive analgesia for open gastric bypass compares favorably with postoperative pain following laparoscopic access for the same surgery. Obesity Surgery 2006; 16: 807–808.
  • 33-Visser E, Schug SA. The role of ketamine in pain management. Biomed Pharmacother 2006; 60: 341–348.
  • 34-Singh PM, Panwar R, Borle A, et al. Perioperative analgesic profile of dexmedetomidine infusions in morbidly obese undergoing bariatric surgery: a meta-analysis and trial sequential analysis. Surgery for Obesity and Related Diseases 2017; 13: 1434–1448.
  • 35-Tufanogullari B, White PF, Peixoto MP, et al. Dexmedetomidine infusion during laparoscopic bariatric surgery: the effect on recovery outcome variables. AnesthAnalg. 2008; 106: 1741-8.
  • 36-Gan TJ, Diemunsch P, Habib AS, et al. Society for Ambulatory Anesthesia. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg 2014; 118: 85-113.

Bariatric surgery and perioperative anesthesic approach

Year 2020, , 112 - 121, 20.05.2020

Sezgin Bilgin , Yasemin Burcu Üstün , Ersin Köksal

https://doi.org/10.7197/cmj.vi.615546

Abstract

Despite healthy lifestyle campaigns and diet programs Obesity is still a global problem. Considering this fact, the increase in obese patients undergoing bariatric surgery is inevitable. Since obesity is affecting many organ systems, the perioperative management of the bariatric surgical patient provides a number of challenges. Preoperative assessment and preparation considering the specific pathophysiology of this patients are important to reduce mortality and morbidity. Anesthesia management and postoperative care should also be performed with consideration of the risks and comorbidities of these patients. This review will focus on the preoperative, peroperative and postoperative anesthesia management of bariatric surgical patients. 

Keywords

anesthesia bariatric surgery obesity

References

  • 1- Taşkın M, Zengin SÜ, Taşkın HE, Bariyatrik ve Metabolik Cerrahinin Tarihçesi, Turkiye Klinikleri J Gen Surg-Special Topics. 2015;8(3):1-5.
  • 2- Buchwald H. The Evolution of Metabolic/Bariatric Surgery. Obes Surg 2014; 24: 1126-1135.
  • 3- Nightingale CE, Margarson MP, Shearer E, et al. Association of Anaesthetists of Great Britain; Ireland Society for Obesity and Bariatric Anaesthesia. Peri-operative management of the obese surgical patient 2015 Jul;70:859-76.
  • 4- Frey WC &Pilcher J. Obstructivesleep-related breathing disorders in patients evaluated for bariatric surgery. Obesity Surgery 2003; 13: 676–683.
  • 5- Hallowell PT, Stellato TA, Schuster M et al. Potentially life-threatening sleep apnea is unrecognized without aggressive evaluation. AmericanJournal of Surgery2007; 193: 364–367.
  • 6- ASA guidlines OSA Practice Guidelines for the Perioperative Management of Patients with Obstructive Sleep Apnea: An Updated Report by the American Society of Anesthesiologists Task Force on Perioperative Management of Patients with Obstructive Sleep Apnea. Anesthesiology 2014;120(2):268-286.
  • 7- Acar HV, Kaya A, Yucel F, et al. Obstruktif Uyku Apnesi Tarama Testi Olarak Kullanılan STOP-Bang Testinin Turk Populasyonunda Gecerliliğinin Saptanması Turk J Anaesth Reanim 2013; 41: 115-20.
  • 8- Juvin P, Lavaut E, Dupont H, et al. Difficult tracheal intubation is more common in obese than in lean patients. Anesth Analg. 2003;97(2):595–600.
  • 9- Ezri T, MedalionB,Weisenberg M, et al. Increased Body mass index per se is not a predictor of difficult laryngoscopy. Can J Anaesth. 2003;50(2):179–83.
  • 10- Kristensen MS. Airway management and morbid obesity.Eur J Anaesthesiol 2010;27:923–927.
  • 11- Yao, F.-S.F.. (2012). Yao & Artusio's anesthesiology: Problem-oriented patient management: Seventh edition.
  • 12- Blokhin IO, Lentz SR. Mechanisms of thrombosis in obesity. Current Opinion in Hematology 2013; 20: 437–44.
  • 13- Parkin L, Sweetland S, Balkwill A, Green J, Reeves G, Beral V. Body massindex, surgery, and risk of venous thromboembolism in middle-aged women: a cohort study. Circulation 2012; 125: 1897–904.
  • 14- Magee CJ, Barry J, Javed S, Macadam R, Kerrigan D. Extended thromboprophylaxis reduces incidence of postoperative venous thromboembolism in laparoscopic bariatric surgery. Surgery for Obesity and Related Diseases 2010; 6:322–5.
  • 15- Schumann R, Anaesthesia for bariatric surgery. Best Practice&Research Clinical Anaesthesiology 2011; 25: 83–93.
  • 16- Hanley MJ, Abernethy DR, Greenblatt DJ. Effect of obesity on the pharmacokinetics of drugs in humans. Clinical Pharmacokinetics 2010; 49: 71–87.
  • 17- De Baerdemaeker LEC, Mortier EP, Struys MMRF. Pharmacokinetics in obesepatients.ContinuingEducation in Anaesthesia, Critical Care&Pain 2004: 4; 152-155.
  • 18- Soleimanpour H, Safari S, Sanaie S, Nazari M, Alavian SM. Anesthetic Considerations in Patients Undergoing Bariatric Surgery: A Review Article. Anesth Pain Med. 2017 Jul 11;7(4):e57568.
  • 19- Ingrande J, Lemmens HJ. Dose adjustment of anesthetics in the morbidly obese. Br J Anaesth. 2010;105 Suppl 1:i16-23. 20- Leykin Y, Miotto L, Pellis T. Pharmacokinetic considerations in the obese. Best Practice&Research Clinical Anaesthesiology 2011; 25: 27–36.
  • 21- Fernandez-Bustamante A, Hashimoto S, Serpa Neto A, et al. Perioperative lung protective ventilation in obese patients. BMCAnesthesiol. 2015;15:56.
  • 22- Pösö T, Kesek D, Aroch R, Winsö O. Morbid Obesity and Optimization of Preoperative Fluid Therapy. Obesity Surgery 2013; 23: 1799–1805.
  • 23- Pösö T, Kesek D, Aroch R, WinsöO. Rapid weight loss is associated with perioperative hypovolemia in morbidly obese patients.ObesSurg. 2013; 23: 306-13.
  • 24- PösöT, WinsöO, ArochR, KesekD. Perioperative fluid guidance with transthoracic echocardiography and pulse contour device in morbidly obese patients. Obes Surg. 2014; 24:2117-25.
  • 25- Brodsky JB, Mariano ER. Regional anaesthesia in the obese patient: Lost landmarks and evolving ultrasound guidance. Best Pract Res Clin Anaesthesiol. 2011; 25: 61–72.
  • 26- Huerta S, DeShields S, Shpiner R, et al. Safety and efficacy of postoperative continuous positive airway pressure to prevent pulmonary complications after Roux-en-Y gastric bypass. Journal of Gastrointestinal Surgery 2002; 6: 354–358.
  • 27- Ramirez A, Lalor PF, Szomstein S, Rosenthal J. Continuous positive airway pressure in the immediate postoperative period after laparoscopic Roux-en-Y gastric bypass: is it safe? Surgery for Obesity and Related Diseases2009; 5: 544–546.
  • 28-Thorell A, MacCormick AD, Awad S, et al. Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations. World J Surg 2016; 40:2065–2083.
  • 29-Porhomayon J, Leissner KB, El-Solh AA, Nader ND. Strategies in Postoperative Analgesia in the Obese Obstructive Sleep Apnea Patient. Clin J Pain2013;29:998–1005.
  • 30-Schug SA, Raymann A. Postoperative pain management of the obese patient. Best Pract Res Clin Anaesthesiol. 2011; 25.73-81.
  • 31-Govindarajan R, Ghosh B, Sathyamoorthy MK, et al. Efficacy of ketorolac in lieu of narcotics in the operative management of laparoscopic surgery for morbid obesity. Surgery for Obesity and Related Diseases 2005; 1: 530–535.
  • 32- Kamelgard J. Combined preemptive and preventive analgesia for open gastric bypass compares favorably with postoperative pain following laparoscopic access for the same surgery. Obesity Surgery 2006; 16: 807–808.
  • 33-Visser E, Schug SA. The role of ketamine in pain management. Biomed Pharmacother 2006; 60: 341–348.
  • 34-Singh PM, Panwar R, Borle A, et al. Perioperative analgesic profile of dexmedetomidine infusions in morbidly obese undergoing bariatric surgery: a meta-analysis and trial sequential analysis. Surgery for Obesity and Related Diseases 2017; 13: 1434–1448.
  • 35-Tufanogullari B, White PF, Peixoto MP, et al. Dexmedetomidine infusion during laparoscopic bariatric surgery: the effect on recovery outcome variables. AnesthAnalg. 2008; 106: 1741-8.
  • 36-Gan TJ, Diemunsch P, Habib AS, et al. Society for Ambulatory Anesthesia. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg 2014; 118: 85-113.
There are 35 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Reviews
Authors

Sezgin Bilgin 0000-0002-3031-8488

Yasemin Burcu Üstün 0000-0002-2628-7543

Ersin Köksal 0000-0003-1780-151X

Publication Date May 20, 2020
Acceptance Date April 28, 2020
Published in Issue Year 2020

Cite

AMA Bilgin S, Üstün YB, Köksal E. Bariatric surgery and perioperative anesthesic approach. CMJ. May 2020;42(1):112-121. doi:10.7197/cmj.vi.615546