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Morbid obesity, anesthesia, anaesthesia,

V V Likhvantsev, A V Mironenko, M V Gabitov, Iu V Skripkin, O V Isaev, M P Danilov
Early patient's activation is the best method of prophylaxis of many complications of the postoperative period. Patients with obesity are at high risk of developing complications in respiratory system. The following clinical report is about the successful implementation of the shortened postoperative period program in patient with morbid obesity after general desflurane maintained anesthesia and, at the same time, epidural ropivacaine-based anesthesia. Anesthesia lasted for 10 hours. The intraoperative period was well controlled and characterized with stable hemodynamic indexes...
May 2014: Anesteziologiia i Reanimatologiia
S Fyneface-Ogan, J D Ojule
Peripartum cardiomyopathy is a potentially fatal form of heart failure associated with pregnancy. A 27-year-old Nigerian woman, gravida 1, para 0, presented at 31 weeks' gestation with no previous history of hypertension heart disease, but morbidly obese (body mass index of 42 kg/m2), with uncontrolled and hypertension, severe pulmonary oedema who required an urgent Caesarean section is presented. The patient was admitted into the hospital's ICU for stabilisation. She was placed on oxygen by non-rebreathing face mask while receiving intravenous labetalol and frusemide...
April 2014: Nigerian Journal of Medicine: Journal of the National Association of Resident Doctors of Nigeria
Mark C Bellamy, Michael P Margarson
BACKGROUND: As a result of the increasing prevalence of obesity in the UK, anesthetists are increasingly encountering overweight and obese patients in routine practice. There is currently a paucity of evidence to guide best clinical practice for anesthetists managing overweight and obese patients. The current guidelines from the Association of Anaesthetists of Great Britain and Ireland (AAGBI), entitled Peri-Operative Management of the Morbidly Obese Patient, give an excellent overview of organizational issues, but leave much clinical detail to the discretion of the individual clinician...
2013: Perioperative Medicine
J Douglass, J Fraser, J Andrzejowski
We describe the awake fibreoptic intubation followed by awake prone positioning of a woman weighing 180 kg with body mass index of 62 kg.m(-2) requiring emergency lumbar discectomy for cauda equina syndrome. This approach was taken to overcome difficulties in transfering an anaesthetised patient on to the operating table. Following topical anaesthesia with lidocaine and low-dose remifentanil infusion, oral intubation was performed using a split oral airway to guide the fibrescope. The patient positioned herself on the Jackson operating table, following which general anaesthesia was induced...
February 2014: Anaesthesia
E L Dolbneva, V I Stamov, S V Gavrilov, V M Mizikov
UNLABELLED: We evaluated the Intubating Laryngeal MAsk (ILMA Fastrach) efficacy for airway management, ventilation and blind intubation in obese and overweight patients. Methods. 50 adult patients (22 men and 28 women) with predicted difficult trachea intubation (PDTI), undergoing general anaesthesia with ILMA were included in this study. ILMA was selected according to gender: ILMA No 5 for men and No 4 for women. PREMEDICATION: diazepam and H,-blockers. Anaesthesia induction: midazolam 0...
March 2013: Anesteziologiia i Reanimatologiia
I A Salov, D V Marshalov, E M Shifman, A P Petrenko
This review presents principals of complications prevention, anaesthesia methods choose, preoperative preparation, anaesthesia management and postoperative care in morbid obese patients.
November 2012: Anesteziologiia i Reanimatologiia
Iljaz Hodzovic
The Fourth National Audit Project (NAP4) was set up by the Royal College of Anaesthetists and Difficult Airway Society to provide an insight into major complications of airway management in the United Kingdom. The NAP4 found that one serious airway complication such as death, brain damage, the need for surgical airway or unexpected intensive care admission, was reported for every 5500 general anaesthetics. Most of the events happened during daytime to a senior experienced clinicians. Airway assessment was not recorded before surgery in 74% of patients that ended up with life threatening airway complications...
September 2012: Acta Clinica Croatica
S Fyneface-Ogan, D S Abam, C Numbere
BACKGROUND: The prevalence of obesity is on the upward trend world-wide. This epidemic has challenging implications for anaesthetists, following the anthropometric changes associated with the disease. OBJECTIVE: To highlight some of the challenges, the management and the lessons learnt during the management of this patient. METHODS: This is a case report of a 52-year old super morbidly obese, diabetic, and hypertensive patient that presented for total abdominal hysterectomy...
June 2012: African Health Sciences
S Jaber, Y Coisel, G Chanques, E Futier, J-M Constantin, P Michelet, M Beaussier, J-Y Lefrant, B Allaouchiche, X Capdevila, E Marret
We conducted an observational prospective multicenter study to describe the practices of mechanical ventilation, to determine the incidence of use of large intra-operative tidal volumes (≥10 of ideal body weight) and to identify patient factors associated with this practice. Of the 2960 patients studied in 97 anaesthesia units from 49 hospitals, volume controlled mode was the most commonly used (85%). The mean (SD) tidal volume was 533 (82) ml; 7.7 (1.3) (actual weight) and 8.8 (1.4) ml...
September 2012: Anaesthesia
Lars Hyldborg Lundstrøm
Several studies have identified difficult airway management including a difficult tracheal intubation of patients undergoing general anaesthesia as a major cause of anaesthesia-related morbidity and mortality. Therefore it is presumed that a difficult tracheal intubation is a surrogate marker for morbidity and mortality, and by reducing the prevalence of difficult tracheal intubation then morbidity and mortality will be reduced as well. From the Danish Anaesthesia Database (DAD), we retrieved a cohort of consecutive patients planned and attempted for tracheal intubation by direct laryngoscopy...
April 2012: Danish Medical Journal
R Fuzier
OBJECTIVE: To detail specificity of regional anaesthesia techniques in the obese patient. DATA SOURCES: Articles were selected from Medline database using the combination of the following keywords: obesity, peripheral nerve block, spinal anaesthesia, epidural, morbidity, mortality. STUDY SELECTION: Most recent original articles or review have mainly been selected. Some case reports that highlighted specific points were added. DATA EXTRACTION: Articles were analyzed for advantages and drawbacks, and risks of different techniques in obese patient...
March 2012: Annales Françaises D'anesthèsie et de Rèanimation
G Kiss, J Butler
A 73-year-old morbidly obese female patient (weight 125 kg, height 156 cm) was scheduled for cataract surgery of her right eye. Due to a number of severe co-morbidities general anaesthesia was contraindicated. However the patient was very anxious and requested sedation if the procedure was to be undertaken under local anaesthesia. She responded very positively to the proposal of utilising perioperative hypnosis. Hypnotic induction was achieved with the heavy eyelid technique, putting the patient into trance within 30 seconds...
November 2011: Anaesthesia and Intensive Care
L Kirkham, M Thomas
No abstract text is available yet for this article.
September 2011: British Journal of Hospital Medicine
T Gaszynski, T Szewczyk, W Gaszynski
BACKGROUND: Complete and fast recovery of neuromuscular function is very important in morbidly obese patients because of the possible influence of postoperative residual curarization (PORC) on respiratory function in the postoperative period. Recent reports underline incidences of the residual influence of neuromuscular blocking agents. METHODS: Seventy morbidly obese (BMI >40 kg m(-2)) patients requiring general anaesthesia and receiving rocuronium for muscle relaxation were randomly assigned into two groups: at the end of the anaesthetic procedure, one group received sugammadex 2 mg kg(-1) of corrected body weight (Group SUG) and the other group received neostigmine 0...
February 2012: British Journal of Anaesthesia
Tomasz Gaszynski
BACKGROUND: The type of anaesthetic used affects the cardiovascular function in morbidly obese patients during pneumoperitoneum. In this prospective randomized study, we evaluated the influence of inhalation anaesthesia with sevoflurane or intravenous anaesthesia with propofol on haemodynamic performance in obese patients during laparoscopy. METHODS: Patients scheduled for laparoscopic bariatric procedures were randomly divided into two groups: sevoflurane (group S) or propofol (group P)...
July 2011: Anestezjologia Intensywna Terapia
Tomi Pösö, Doris Kesek, Ola Winsö, Staffan Andersson
BACKGROUND AND OBJECTIVE: The interest in bariatric surgery is growing. Morbidly obese patients have an increased risk of hypoxia and decreased blood pressure during rapid sequence induction (RSI). Alternate RSI methods that provide cardiovascular and respiratory stability are required. With this in mind, we evaluated a method for volatile RSI in morbidly obese patients. DESIGN: Observational study. METHODS: Thirty-four patients with mean BMI 42...
November 2011: European Journal of Anaesthesiology
H S Mace, M J Paech, N J McDonnell
Obesity is increasing in the population as a whole, and especially in the obstetric population, among whom pregnancy-induced physiological changes impact on those already present due to obesity. In particular, changes in the cardiovascular and respiratory systems during pregnancy further alter the physiological effects and comorbidities of obesity. Obese pregnant women are at increased risk of diabetes, hypertensive disorders of pregnancy, ischaemic heart disease, congenital malformations, operative delivery postpartum infection and thromboembolism...
July 2011: Anaesthesia and Intensive Care
M Boutonnet, V Faitot, H Keïta
OBJECTIVE: Reviewing problems related to the airway management in obstetrics, taking into account the recent evolutions of the anaesthetic practices in obstetrics. DATA SOURCES: A review of the literature in English and French was performed in the Pumed database in April 2010. The first research used the following MeshTerms: "Anesthesia, Obstetrical" [Mesh] AND "Intubation, Intratracheal" [Mesh]. Complementary research used alone or in combination the following keywords: difficult tracheal intubation; failed tracheal intubation; airway; prediction of difficult tracheal intubation; maternal mortality; maternal morbidity; liability; aspiration pneumonia and obstetrical anesthesia...
September 2011: Annales Françaises D'anesthèsie et de Rèanimation
P Van Lancker, B Dillemans, T Bogaert, J P Mulier, M De Kock, M Haspeslagh
To date, the dosing of sugammadex is based on real body weight without taking fat content into account. We compared the reversal of profound rocuronium-induced neuromuscular blockade in morbidly obese patients using doses of sugammadex based on four different weight corrections. One hundred morbidly obese patients, scheduled for laparoscopic bariatric surgery under propofol-sufentanil anaesthesia, were randomly assigned four groups: ideal body weight; ideal body weight + 20%; ideal body weight + 40%; and real body weight...
August 2011: Anaesthesia
M F Haque, M H Rashid, M S Rahaman, M R Islam
Per-operative shivering following spinal anaesthesia is a common problem in the operation theatre. Adequate management of shivering during operation is one of the goals of anesthesiologists for the benefit of the patient. Because there are many unpleasant and harmful effects caused by shivering in many patients especially respiratory and cardiac disease patients. For this reason aggressive and optimal treatment of per-operative shivering is essential to reduce the morbidity of the patients. Our observations were that occurrence of shivering was more in younger patients than older patients, thin patients than obese patients, anxious patients than non-anxious patients and more frequent in patients who received vasoconstrictor drugs, administration of fluid at running rate just before or during operation, administration of cold local anaesthetic agents (by taking drug from the freeze) into subarachnoid space...
April 2011: Mymensingh Medical Journal: MMJ
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