Yıl 2014,
Cilt: 36 Sayı: 3, 409 - 414, 01.03.2014
Öz
Abstract
The obese patient presents many challenges to anaesthesiologist. A good understanding of the pathophysiologic effects of obesity and its anaesthetic implications is important. The anaesthesiologist must recognize increased risks and comorbidities inherent to the obese patient and manage accordingly, optimizing multisystem function in the perioperative period that leads to successful outcomes. Perioperative issues such as intravenous access, difficulty in measuring non invasive blood pressure, difficult spinal, epidural and difficult airway should be anticipated and planned.
Keywords: Obesity, anaesthesia, anaesthetic considerations
Anahtar Kelimeler
Kaynakça
- Bray GA. Pathophysiology of obesity. Am J Clin Nutr 1992; 55: 488-94.
- Bray GA. Complications of obesity. Ann Intern Med 1985; 103: 1052-62.
- Jensen MD. Health consequences of fat distribution. Horm Res 1997; S48: 88-92. Koenig SM. Pulmonary complications of obesity. Am J Med Sci 2001; 321: 249
- Douglas NJ, Polo O. Pathogenesis of obstructive sleep apnoea/ hypopnoea syndrome. Lancet 1994; 344: 653-5.
- Vgontzas AN, Tan TL, Bixler EO, Martin LF, Shubert D, Kales A. Sleep apnea and sleep distribution in obese patients. Arch Int Med 1994; 154: 1705-11.
- Lotia S, Bellamy MC. Anaesthesia and morbid obesity.Critical Care & Pain 2008; 8: 151-6.
- Adams JP, Murphy PG. Obesity in anaesthesia and intensive care. Br J Anaesth 2000; 85: 91-108.
- Alpert MA, Hashimi MW. Obesity and the heart. Am J Med Sci 1993; 306: 117
- Vaughan RW, Bauer S, Wise L. Volume and pH of gastric juice in obese patients. Anesthesiology 1975; 43: 686-9.
- Bansal T, Hooda S. Awake intubation- a viable approach for preventing aspiration in patients undergoing emergency surgery after administration of oral contrast material. Egyptian Journal of Anaesthesia 2013; 29: 179-80.
- Neill T, Allam J. Anaesthetic considerations and management of the obese patient presenting for bariatric surgery. Current anaesthesia & Critical Care 2010; 21: 16Brodsky JB. Anesthetic management of the morbidly obese patient. Int Anesthesiol Clin 1986; 24: 93-103.
- Brodsky JB, Lemmens HJ, Brock-Utne JG, Vierra M, Saidman LJ. Morbid obesity and tracheal intubation. Anesth Analg 2002; 94: 732-6.
- Rao DP, Rao VA. Morbidly obese parturient. Challenges for the anaesthesiologist, including managing the difficult airway in obstetrics. What is new? Indian J Anaesth 2010; 54: 508-21.
- Warner MA, Warner DO, Harper CM, Schroeder DR, Maxson PM. Ulnar neuropathy in medical patients. Anesthesiology 2000; 92: 613-5.
- Dority J, Hassan Z, Chau D. Anesthetic implications of obesity in the surgical patient. Clin Colon Rectal Surg 2011; 24: 222-8.
- Bansal T, Kumar P, Hooda S. Regional anaesthesia-still a comfortable choice in morbidly obese parturient. Colombian Journal of Anaesthesiology 2013; 41: 302
- Wallace DH, Currie JM, Gilstrap LC, Santos R. Indirect sonographic guidance for epidural anaesthesia in obese pregnant patients. Reg Anesth 1992; 17: 233-6. Shah N, Lattoo Y. Anaesthetic management of obese parturient. BJMP 2008; 1: 15Dixon BJ, Dixon JB, Carden JR, Burn AJ, Schachter LM, Playfair JM. Preoxygenation is more effective in the 25 head up position than in the supine position in severely obese patients: A randomized controlled study. Anesthesiology 2005; 102: 1110-5.
- Gander S, Frascarolo P, Suter M, Spahn DR, Magnusson L. Positive end expiratory pressure during induction of general anaesthesia increases duration of non hypoxic apnea in morbidly obese patients. Anesth Analg 2005; 100: 580-4.
- Ankichetty SP, Angle P, Joselyn AS, Chinnappa V, Halpern S. Anesthetic considerations of parturients with obesity and obstructive sleep apnea. J Anaesthesiol Clin Pharmacol 2012; 28: 436-43.
Yıl 2014,
Cilt: 36 Sayı: 3, 409 - 414, 01.03.2014
Öz
Obez hastalar anestezistlere çeşitli sorunlar çıkarır. Obezitenin patofizyolojik etkileri ve anesteziklerle etkileşimlerinin iyi anlaşılması önemlidir. Anestezistler obez hastalardaki risk ve komorbidite artışlarını farketmeli ve perioperatif dönemde başarılı sonuçlar elde edebilmek için multisistem fonksiyonlarını optimize ederek buna göre hareket etmelidir. İntravenöz girişim, noninvaziv kan basıncı ölçümü, spinal-epidural anestezi ve havayolu ulaşımındaki zorluklar önceden tahmin edilerek gerekli planlama yapılmalıdır.
Anahtar Kelimeler
Kaynakça
- Bray GA. Pathophysiology of obesity. Am J Clin Nutr 1992; 55: 488-94.
- Bray GA. Complications of obesity. Ann Intern Med 1985; 103: 1052-62.
- Jensen MD. Health consequences of fat distribution. Horm Res 1997; S48: 88-92. Koenig SM. Pulmonary complications of obesity. Am J Med Sci 2001; 321: 249
- Douglas NJ, Polo O. Pathogenesis of obstructive sleep apnoea/ hypopnoea syndrome. Lancet 1994; 344: 653-5.
- Vgontzas AN, Tan TL, Bixler EO, Martin LF, Shubert D, Kales A. Sleep apnea and sleep distribution in obese patients. Arch Int Med 1994; 154: 1705-11.
- Lotia S, Bellamy MC. Anaesthesia and morbid obesity.Critical Care & Pain 2008; 8: 151-6.
- Adams JP, Murphy PG. Obesity in anaesthesia and intensive care. Br J Anaesth 2000; 85: 91-108.
- Alpert MA, Hashimi MW. Obesity and the heart. Am J Med Sci 1993; 306: 117
- Vaughan RW, Bauer S, Wise L. Volume and pH of gastric juice in obese patients. Anesthesiology 1975; 43: 686-9.
- Bansal T, Hooda S. Awake intubation- a viable approach for preventing aspiration in patients undergoing emergency surgery after administration of oral contrast material. Egyptian Journal of Anaesthesia 2013; 29: 179-80.
- Neill T, Allam J. Anaesthetic considerations and management of the obese patient presenting for bariatric surgery. Current anaesthesia & Critical Care 2010; 21: 16Brodsky JB. Anesthetic management of the morbidly obese patient. Int Anesthesiol Clin 1986; 24: 93-103.
- Brodsky JB, Lemmens HJ, Brock-Utne JG, Vierra M, Saidman LJ. Morbid obesity and tracheal intubation. Anesth Analg 2002; 94: 732-6.
- Rao DP, Rao VA. Morbidly obese parturient. Challenges for the anaesthesiologist, including managing the difficult airway in obstetrics. What is new? Indian J Anaesth 2010; 54: 508-21.
- Warner MA, Warner DO, Harper CM, Schroeder DR, Maxson PM. Ulnar neuropathy in medical patients. Anesthesiology 2000; 92: 613-5.
- Dority J, Hassan Z, Chau D. Anesthetic implications of obesity in the surgical patient. Clin Colon Rectal Surg 2011; 24: 222-8.
- Bansal T, Kumar P, Hooda S. Regional anaesthesia-still a comfortable choice in morbidly obese parturient. Colombian Journal of Anaesthesiology 2013; 41: 302
- Wallace DH, Currie JM, Gilstrap LC, Santos R. Indirect sonographic guidance for epidural anaesthesia in obese pregnant patients. Reg Anesth 1992; 17: 233-6. Shah N, Lattoo Y. Anaesthetic management of obese parturient. BJMP 2008; 1: 15Dixon BJ, Dixon JB, Carden JR, Burn AJ, Schachter LM, Playfair JM. Preoxygenation is more effective in the 25 head up position than in the supine position in severely obese patients: A randomized controlled study. Anesthesiology 2005; 102: 1110-5.
- Gander S, Frascarolo P, Suter M, Spahn DR, Magnusson L. Positive end expiratory pressure during induction of general anaesthesia increases duration of non hypoxic apnea in morbidly obese patients. Anesth Analg 2005; 100: 580-4.
- Ankichetty SP, Angle P, Joselyn AS, Chinnappa V, Halpern S. Anesthetic considerations of parturients with obesity and obstructive sleep apnea. J Anaesthesiol Clin Pharmacol 2012; 28: 436-43.
Toplam 19 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Bölüm | Derlemeler |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Mart 2014 |
| Yayımlandığı Sayı | Yıl 2014Cilt: 36 Sayı: 3 |