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Bariatric anaesthesia

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https://www.readbyqxmd.com/read/29188308/ureteroscopy-from-the-recent-past-to-the-near-future
#1
REVIEW
José Manuel Reis Santos
Stone surgery is one of oldest surgical practices undertaken by man. Hippocrates refused to let his followers "cut for the stone" and it was only in February 1980, when the first human trial of shock wave therapy on a renal stone was performed with success that a new era in minimally invasive treatment (surgery) for stones was opened up and this condemnation was finally resolved in the Hippocratic Oath. Endoscopy, using natural orifices, supported by anaesthesia, incremented by technology and with access to all points along the urinary tract, began by competing with ESWL, but is now the treatment of choice in most cases...
November 29, 2017: Urolithiasis
https://www.readbyqxmd.com/read/29114413/perioperative-factors-affecting-ambulatory-outcomes-following-laparoscopic-adjustable-gastric-banding
#2
Mirsad Dupanovic, Ron Krebill, Iris Dupanovic, John Nachtigal, Melissa Rockford, Walter Orr
Objective: Morbidly obese patients are traditionally hospitalised following bariatric surgery. However, laparoscopic-adjustable gastric banding (LAGB) is amenable for ambulatory care. We hypothesised that the majority of patients can receive an ambulatory LAGB and that both surgical and anaesthetic perioperative factors will significantly affect non-ambulatory LAGB outcomes. Methods: Medical records of 201 consecutive LAGB patients performed at the University of Kansas Medical Centre during a 3-y period were reviewed...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28794858/monitoring-respiration-and-oxygen-saturation-in-patients-during-the-first-night-after-elective-bariatric-surgery-a-cohort-study
#3
Liselott Wickerts, Sune Forsberg, Frederic Bouvier, Jan Jakobsson
Background: Obstructive sleep apnoea and obese hypoventilation is not uncommon in patients with obesity. Residuals effect from surgery/anaesthesia and opioid analgesics may worsen respiration during the first nights after bariatric surgery. The aim of this observational study was to monitor respiration on the first postoperative night following elective bariatric surgery. Methods: This observational study aimed to determine the incidence and severity of hypo/apnoea in low risk obsess patients undergoing elective bariatric surgery in general anesthaesia...
2017: F1000Research
https://www.readbyqxmd.com/read/28726143/endoscopic-management-of-post-laparoscopic-sleeve-gastrectomy-stenosis
#4
Valérie Deslauriers, Amélie Beauchamp, Fabio Garofalo, Henri Atlas, Ronald Denis, Pierre Garneau, Radu Pescarus
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is the most popular bariatric surgery worldwide. Gastric sleeve stenosis is the most common postoperative complication, occurring in up to 3.9% of the cases. Current treatment options include endoscopic treatments, such as dilatations and stent placement as well as surgical revisions such as laparoscopic Roux-en-Y gastric bypass (LRYGB), wedge gastrectomy or seromyotomy. METHODS: A retrospective analysis of our prospectively collected therapeutical endoscopy database was performed between January 2014 and February 2017...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28707209/anaesthetic-preparation-of-obese-patients-current-status-on-optimal-work-up
#5
REVIEW
Asta Lukosiute, Anil Karmali, Jonathan Mark Cousins
PURPOSE OF REVIEW: With the prevalence of obesity rapidly growing, bariatric anaesthesia becomes everyday anaesthesia rather than a subspecialty. In this review, we are aiming to draw attention to this complex group of patients and their comorbidities, relevant to everyday practice for contemporary anaesthetists. RECENT FINDINGS: We wanted to focus greatly on sleep-related breathing disorders, because preoperative screening, diagnosis and treatment of the aforementioned make a huge impact in the improvement of preoperative morbidity and mortality, including positive effects on the cardiovascular system...
September 2017: Current Obesity Reports
https://www.readbyqxmd.com/read/28474243/-preoperative-fasting-period-of-fluids-in-bariatric-surgery
#6
P Simon, U-C Pietsch, R Oesemann, A Dietrich, H Wrigge
BACKROUND: Aspiration of stomach content is a severe complication during general anaesthesia. The DGAI (German Society for Anesthesiology and Intensive Care Medicine) guidelines recommend a fasting period for liquids of 2 h, with a maximum of 400 ml. Preoperative fasting can affect the patients' recovery after surgery due to insulin resistance and higher protein catabolism as a response to surgical stress. OBJECTIVES: The aim of the study was to compare a liberal fasting regimen consisting of up to 1000 ml of liquids until 2 h before surgery with the DGAI recommendation...
July 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28420916/the-effect-of-bariatric-anaesthesia-on-postoperative-pulmonary-functions
#7
Ozcan Piskin, Bulent Altinsoy, Murat Cimencan, Bengu Gulhan Aydin, Dilek Okyay, Gamze Kucukosman, Oge Tascilar, Selda Sarikaya, Hilal Ayoglu
OBJECTIVE: To evaluate respiratory function in the post-operative early period of patients undergoing bariatric surgery using the sleeve gastrectomy technique. METHODS: This prospective, observational study was conducted at Bülent Ecevit University Health Application and Research Centre, Zonguldak, Turkey from June to December 2014, and comprised patients with planned bariatric sleeve gastrectomy under general anaesthesia. Participants were visited 12-24 hours before the operation to record accompanying diseases and demographic data...
April 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28374473/post-operative-nausea-and-vomiting-in-bariatric-surgery-patients-an-observational-study
#8
T A Halliday, J Sundqvist, M Hultin, J Walldén
BACKGROUND: The risk of post-operative nausea and vomiting (PONV) in patients undergoing bariatric surgery is unclear. The aim of the study was to investigate the risk of PONV and the use and effectiveness of PONV prophylaxis. METHODS: This prospective observational study included 74 patients undergoing bariatric surgery with total intravenous anaesthesia. Patients were given PONV prophylaxis based on published guidelines and a simplified PONV risk score. Perioperative data were collected and a questionnaire was used at 2, 4, 6, 24, 48 and 72 h after the operation to evaluate PONV...
May 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/27869287/dexmedetomidine-for-attenuating-haemodynamic-response-to-intubation-stimuli-in-morbidly-obese-patients-anaesthetised-using-low-opioid-technique-comparison-with-fentanyl-based-general-anaesthesia
#9
RANDOMIZED CONTROLLED TRIAL
Tomasz Gaszyński, Klaudia Czarnik, Łukasz Łaziński, Wojciech Gaszyński
BACKGROUND: Anaesthesiologists are facing the problem of an increasing population of morbidly obese patients. In order to minimize the risk of opioid-induced postoperative respiratory failure, the intraoperative administration of opioids should be reduced or replaced with other drugs. The purpose of this study was to compare haemodynamic response elicited by intubation in morbidly obese patients between two variants of anaesthesia induction: fentanylbased or low-opioid using dexmedetomidine...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27867510/effect-of-adding-intrathecal-morphine-to-a-multimodal-analgesic-regimen-for-postoperative-pain-management-after-laparoscopic-bariatric-surgery-a-prospective-double-blind-randomized-controlled-trial
#10
Fatma Adel El Sherif, Ahmed Hassan Othman, Ahmad Mohammad Abd El-Rahman, Osama Taha
BACKGROUND: Pain control after bariatric surgery is a major challenge. Our objective was to study the efficacy and safety of intrathecal (IT) morphine 0.3 mg added to bupivacaine 0.5% for postoperative pain after laparoscopic bariatric surgery. METHODS: After local ethics committee approval, 100 morbidly obese patients scheduled for laparoscopic bariatric surgery were enrolled in this study. Patients were randomly assigned into two groups: Group I received IT 0...
November 2016: British Journal of Pain
https://www.readbyqxmd.com/read/27492516/perioperative-respiratory-care-in-obese-patients-undergoing-bariatric-surgery-implications-for-clinical-practice
#11
REVIEW
Sjaak Pouwels, Frank W J M Smeenk, Loes Manschot, Bianca Lascaris, Simon Nienhuijs, R Arthur Bouwman, Marc P Buise
Obesity is an increasing problem worldwide. The number of people with obesity doubled since the 1980's to affect an estimated 671 million people worldwide. Obese patients in general have an altered respiratory physiology and can have an impaired lung function, which leads to an increased risk of developing pulmonary complications during anaesthesia and after bariatric surgery (approximately 8%). Therefore the respiratory management of the bariatric surgical patient provides a number of challenges. This review will focus on the perioperative respiratory care in bariatric surgical patients discussing respiratory physiology in the obese and perioperative respiratory care in bariatric surgery...
August 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27418005/multimodal-analgesia-model-to-achieve-low-postoperative-opioid-requirement-following-bariatric-surgery
#12
K Ky Lam, W Lm Mui
OBJECTIVE: To investigate whether a new anaesthesia protocol can reduce opioid use in obese patients following laparoscopic sleeve gastrectomy. METHODS: This prospective observational case series was conducted in a private hospital in Hong Kong that has been accredited as a Centre of Excellence for Bariatric Surgery. Thirty consecutive patients scheduled for laparoscopic sleeve gastrectomy from 1 January 2015 to 31 March 2015 were reviewed. RESULTS: Of the 30 patients, 14 (46...
October 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27377635/sleeve-gastrectomy-versus-roux-en-y-gastric-bypass-for-type-2-diabetes-and-morbid-obesity-double-blind-randomised-clinical-trial-protocol
#13
Rinki Murphy, Nicholas J Evennett, Michael G Clarke, Steven J Robinson, Lee Humphreys, Bronwen Jones, David D Kim, Richard Cutfield, Lindsay D Plank, Hisham Hammodat, Michael W C Booth
INTRODUCTION: Type 2 diabetes (T2D) in association with obesity is an increasing disease burden. Bariatric surgery is the only effective therapy for achieving remission of T2D among those with morbid obesity. It is unclear which of the two most commonly performed types of bariatric surgery, laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB), is most effective for obese patients with T2D. The primary objective of this study is to determine whether LSG or LRYGB is more effective in achieving HbA1c<6% (<42 mmol/mol) without the use of diabetes medication at 5 years...
July 4, 2016: BMJ Open
https://www.readbyqxmd.com/read/27029656/the-anaesthetic-assessment-management-and-risk-factors-of-bariatric-surgical-patients-requiring-postoperative-intensive-care-support-a-state-wide-five-year-cohort-study
#14
D J R Morgan, K M Ho
Bariatric surgery is a rapidly growing and dynamic discipline necessitating a specialised anaesthetic approach coordinating high-risk patients with appropriate post-operative intensive care (ICU) support. The relationship between the anaesthetic and ICU utilisation after bariatric surgery is poorly understood. All adult bariatric surgery patients admitted to any ICU over a five-year period between 2007 and 2011 in Western Australia were identified from hospital admission records and cross-referenced against the Western Australian Department of Health Data Linkage Unit database...
March 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/26658181/best-anaesthetic-drug-strategy-for-morbidly-obese-patients
#15
REVIEW
Luc De Baerdemaeker, Michael Margarson
PURPOSE OF REVIEW: The purpose of this review is to describe an evidence-based drug strategy applicable to any obese patient, rather than to present one standard 'ideal' anaesthetic drug combination. The ultimate choice of specific drugs in any given situation will depend upon clinician experience, patient specifics, and drug availability. The fundamental principle in anaesthesia for the obese patient is to use the shortest acting, least fat soluble agents to ensure rapid recovery to safe levels of alertness and mobility...
February 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/26363693/-adverse-respiratory-events-after-general-anesthesia-in-patients-at-high-risk-of-obstructive-sleep-apnea-syndrome
#16
Daniela Xará, Júlia Mendonça, Helder Pereira, Alice Santos, Fernando José Abelha
INTRODUCTION: Patients with STOP-BANG score >3 have a high risk of Obstructive sleep apnea. The aim of this study was to evaluate early postoperative respiratory complications in adults with STOP-BANG score >3 after general anesthesia. METHODS: This is a prospective double cohort study matching 59 pairs of adult patients with STOP-BANG score >3 (high risk of obstructive sleep apnea) and patients with STOP-BANG score <3 (low risk of obstructive sleep apnea), similar with respect to gender, age and type of surgery, admitted after elective surgery in the Post-Anaesthesia Care Unit in May 2011...
September 2015: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/26328531/chronic-renin-angiotensin-system-ras-blockade-may-not-induce-hypotension-during-anaesthesia-for-bariatric-surgery
#17
Guido Salvetti, Claudio Di Salvo, Giovanni Ceccarini, Antonio Abramo, Paola Fierabracci, Silvia Magno, Paolo Piaggi, Paolo Vitti, Ferruccio Santini
The use of angiotensin-converting enzyme inhibitors (ACE-I) and angiotensin II receptor blockers (ARB) for the treatment of hypertensive obese patients is steadily increasing. Some studies have reported that the use of these drugs was associated with an increased risk of hypotensive episodes, during general anaesthesia. The number of bariatric procedures is also increasing worldwide, but there is a lack of studies investigating the hypotensive effect of renin-angiotensin system (RAS) blockers in severely obese patients during general anaesthesia for bariatric surgery...
June 2016: Obesity Surgery
https://www.readbyqxmd.com/read/26323734/adverse-respiratory-events-after-general-anesthesia-in-patients-at-high-risk-of-obstructive-sleep-apnea-syndrome
#18
Daniela Xará, Júlia Mendonça, Helder Pereira, Alice Santos, Fernando José Abelha
INTRODUCTION: Patients with STOP-BANG score >3 have a high risk of Obstructive sleep apnea. The aim of this study was to evaluate early postoperative respiratory complications in adults with STOP-BANG score >3 after general anesthesia. METHODS: This is a prospective double cohort study matching 59 pairs of adult patients with STOP-BANG score >3 (high risk of obstructive sleep apnea) and patients with STOP-BANG score <3 (low risk of obstructive sleep apnea), similar with respect to gender, age and type of surgery, admitted after elective surgery in the Post-Anaesthesia Care Unit in May 2011...
September 2015: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/25859266/bariatric-surgery-in-old-age-a-comparative-study-of-laparoscopic-roux-en-y-gastric-bypass-and-sleeve-gastrectomy-in-an-asia-centre-of-excellence
#19
Chih-Kun Huang, Amit Garg, Hsin-Chih Kuao, Po-Chih Chang, Ming-Che Hsin
Bariatric surgery has been proved to be the safest and efficient procedure in treating morbid obese patients, but data is still lacking in the elderly population. The aim of our study was to compare the safety and efficacy of laparoscopic Roux-en-Y gastric bypass (LRYGB) and sleeve gastrectomy (LSG) in patients aged more than 55 years. We performed a retrospective review of a prospectively collected database. All patients with body mass index (BMI) ≧32 kg/m(2) and aged more than 55 years undergoing LRYGB or LSG in BMI Surgery Centre, E-Da Hospital between January 2008 and December 2011 with at least one year of follow up were included for the analysis...
April 2015: Journal of Biomedical Research
https://www.readbyqxmd.com/read/25282446/-observational-study-on-outpatient-sleeve-gastrectomy
#20
R Badaoui, L Rebibo, V Thiel, C Perret, I Popov, A Dhahri, J-M Regimbeau, P Verhaeghe, H Dupont
UNLABELLED: The development of outpatient surgery is one of the major goals of the public health policy in 2010. The purpose of this observational study is to evaluate the feasibility of the laparoscopic sleeve gastrectomy (LSG) in ambulatory. METHODS: This prospective observational study was conducted from May 2011 to June 2013. The procedure was proposed for patients undergoing LSG who were predetermined inclusion criteria. Following preoxygenation, anaesthesia was induced with propofol and sufentanil...
September 2014: Annales Françaises D'anesthèsie et de Rèanimation
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