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Obesity, anesthesia

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https://www.readbyqxmd.com/read/28421314/the-impact-of-body-mass-index-on-the-risk-of-high-spinal-block-in-parturients-undergoing-cesarean-delivery-a-retrospective-cohort-study
#1
Agnes M Lamon, Lisa M Einhorn, Mary Cooter, Ashraf S Habib
PURPOSE: To investigate the hypothesis that the risk of high spinal block is not increased in obese parturients undergoing cesarean delivery compared to non-obese parturients. METHODS: This is a retrospective study at an academic center. We searched the perioperative database for women who underwent cesarean delivery under spinal or combined spinal epidural anesthesia with hyperbaric bupivacaine ≥10.5 mg. A body mass index (BMI) ≥30 kg/m(2) was defined as obese...
April 18, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28417459/does-obesity-complicate-regional-anesthesia-and-result-in-longer-decision-to-delivery-time-for-emergency-cesarean-section
#2
A J Väänänen, J P Kainu, H Eriksson, M Lång, A Tekay, J Sarvela
BACKGROUND: Maternal obesity can cause problems with anesthesia and surgery which may be reflected in emergency cesarean sections (CS) as an increased decision-to-delivery interval (DDI). AIM: To study the association of elevated maternal BMI with DDI and the failure of regional anesthesia. METHODS: Eight hundred and forty-two consecutive emergency CSs during a period of 1 year in a tertiary hospital were studied retrospectively. DDIs were analyzed in Crash and < 30-min urgency categories (n = 528), while the time required to establish regional anesthesia and its success were analyzed for all emergency CS cases...
April 17, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28389063/a-novel-transperitoneal-abdominal-wall-nerve-block-for-postoperative-pain-in-laparoscopic-colorectal-surgery
#3
Jun Nagata, Jun Watanabe, Yusuke Sawatsubashi, Masaki Akiyama, Koichi Arase, Noritaka Minagawa, Takayuki Torigoe, Kotaro Hamada, Yoshifumi Nakayama, Keiji Hirata
BACKGROUND: Although the laparoscopic approach reduces pain associated with abdominal surgery, postoperative pain remains a problem. Ultrasound-guided rectus sheath block and transversus abdominis plane block have become increasingly popular means of providing analgesia for laparoscopic surgery. METHODS: Ninety patients were enrolled in this study. A laparoscopic puncture needle was inserted via the port, and levobupivacaine was injected into the correct plane through the peritoneum...
April 4, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28371877/comprehensive-analysis-of-13-897-consecutive-regional-anesthetics-at-an-ambulatory-surgery-center
#4
Randall J Malchow, Rajnish K Gupta, Yaping Shi, Matthew S Shotwell, Lisa M Jaeger, Clifford Bowens
Objective.:  The authors investigated a wide range of perioperative outcome measures in the context of a robust regional anesthesia practice. Design.:  Comprehensive review of a prospectively collected six-year database. Setting.:  Freestanding, academic ambulatory surgery center. Subjects.:  There were 13,897 consecutive regional anesthetics in 10,338 patients. Methods.:  We investigated patient satisfaction, postoperative nausea and vomiting (PONV), postoperative pain, catheter analgesia, and complications...
March 24, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28356296/sex-dependent-effects-of-antenatal-glucocorticoids-on-insulin-sensitivity-in-adult-sheep-role-of-the-adipose-tissue-renin-angiotensin-system
#5
G Angela Massmann, Jie Zhang, Won Joon Seong, Minhyoung Kim, Jorge P Figueroa
Exposure to glucocorticoids in utero is associated with changes in organ function and structure in the adult. The aims of this study were to characterize the effects of antenatal exposure to glucocorticoids on glucose handling and the role of adipose tissue. Pregnant sheep received betamethasone (Beta, 0.17 mg/kg) or vehicle (V) 24-h apart at 80-days gestation and allowed to deliver at term. At 9 months, male and female offspring were fed at either 100% of nutritional allowance (lean) or ad libitum for 3 months (obese)...
March 29, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28319546/gastric-fluid-volume-change-after-oral-rehydration-solution-intake-in-morbidly-obese-and-normal-controls-a-magnetic-resonance-imaging-based-analysis
#6
Toshie Shiraishi, Dai Kurosaki, Mitsuyo Nakamura, Taiji Yazaki, Satomi Kobinata, Yosuke Seki, Kazunori Kasama, Hideki Taniguchi
BACKGROUND: Although preoperative fluid intake 2 hours before anesthesia is generally considered safe, there are concerns about delayed gastric emptying in obese subjects. In this study, the gastric fluid volume (GFV) change in morbidly obese subjects was investigated after ingesting an oral rehydration solution (ORS) and then compared with that in nonobese subjects. METHODS: GFV change over time after the ingestion of 500 mL of ORS containing 2.5% carbohydrate (OS-1) was measured in 10 morbidly obese subjects (body mass index [BMI], >35) scheduled for bariatric surgery and 10 nonobese (BMI, 19-24) using magnetic resonance imaging...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28298763/effect-of-switching-between-pressure-controlled-and-volume-controlled-ventilation-on-respiratory-mechanics-and-hemodynamics-in-obese-patients-during-abdominoplasty
#7
Medhat Mikhail Messeha
BACKGROUND: The ideal intraoperative ventilation strategy in obese patients remains obscure. This prospective, randomized study was designed to evaluate the effect of pressure-controlled ventilation (PCV) before or after volume-controlled ventilation (VCV) on lung mechanics and hemodynamics variables in obese patients subjected to abdominoplasty operation. PATIENTS AND METHODS: The study included forty patients with body mass index 30-45 kg/m(2) subjected to abdominoplasty...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28243855/optimal-propofol-induction-dose-in-morbidly-obese-patients-a-randomized-controlled-trial-comparing-the-bispectral-index-and-lean-body-weight-scalar
#8
Yamini Subramani, Waleed Riad, Frances Chung, Jean Wong
PURPOSE: Propofol dosing based on total body weight (TBW) can lead to overdosing in morbidly obese (MO) patients. Our aim was to determine whether an induction dose of propofol based on a bispectral index (BIS) target is better for achieving loss of consciousness in MO patients than dosing based on lean body weight (LBW). METHODS: Sixty MO patients with a body mass index (BMI) of ≥ 40 kg·m(-2) were randomized to either BIS- or LBW-based propofol dosing groups...
February 27, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28243748/pilot-study-comparing-post-anesthesia-care-unit-length-of-stay-in-moderately-and-severely-obese-children
#9
Hina Walia, Onur Balaban, Megan Jacklen, Dmitry Tumin, Vidya Raman, Joseph D Tobias
OBJECTIVE: Obesity is a risk factor for surgical complications in adults and children. Differences in postsurgical outcomes according to severity of obesity [moderate: 95-98th age-gender-specific body mass index (BMI) percentile versus severe: ≥99th percentile] in children remain unclear. This study compared post-anesthesia care unit (PACU) stay and hospital admission between severely obese children and moderately obese children undergoing surgery. METHODS: In a retrospective review over a 6-month period, obese children, 2-18 years of age undergoing surgery were identified...
February 27, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28238111/use-of-fentanyl-in-adolescents-with-clinically-severe-obesity-undergoing-bariatric-surgery-a-pilot-study
#10
Janelle D Vaughns, Victoria C Ziesenitz, Elaine F Williams, Alvina Mushtaq, Ricarda Bachmann, Gisela Skopp, Johanna Weiss, Gerd Mikus, Johannes N van den Anker
BACKGROUND: The number of obese pediatric patients requiring anesthesia is rapidly increasing. Although fentanyl is a commonly used narcotic during surgery, there are no pharmacokinetic (PK) data available for optimal dosing of fentanyl in adolescents with clinically severe obesity. MATERIALS AND METHODS: An institutional review board-approved exploratory pilot study was conducted in six adolescents aged 14-19 years undergoing bariatric surgery. Mean total body weight (TBW) and mean BMI were 137...
February 25, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28236860/effect-of-equipotent-doses-of-bupivacaine-and-ropivacaine-in-high-fat-diet-fed-neonatal-rodent-model
#11
Ying-Dong Lian, Zong-Xiang Chen, Kang-Ru Zhu, Shu-Yin Sun, Li-Ping Zhu
OBJECTIVES: The increase in the prevalence of obesity presents a significant health and economic problem. Obesity has been reported to be a major contributor to variety of chronic diseases. Childhood obesity has been rising over the past decades leading to various complications in health. Millions of infants and children undergo surgery every year on various health grounds. The present investigation was undertaken to evaluate the effect of spinal anesthesia of equipotent doses of ropivacaine and bupivacaine on over-weight neonatal rats...
March 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28235511/increasing-body-mass-index-predicts-increasing-difficulty-failure-rate-and-time-to-discovery-of-failure-of-epidural-anesthesia-in-laboring-patients
#12
Ayse O Kula, Matthias L Riess, Elizabeth H Ellinas
STUDY OBJECTIVE: Obese parturients both greatly benefit from neuraxial techniques, and may represent a technical challenge to obstetric anesthesiologists. Several studies address the topic of obesity and neuraxial analgesia in general, but few offer well described definitions or rates of "difficulty" and "failure" of labor epidural analgesia. Providing those definitions, we hypothesized that increasing body mass index (BMI) is associated with negative outcomes in both categories and increased time needed for epidural placement...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28224030/safety-and-effectiveness-of-sleeve-gastrectomy-versus-gastric-bypass-one-year-results-of-tehran-obesity-treatment-study-tots
#13
Maryam Barzin, Alireza Khalaj, Mohammad Ali Motamedi, Pravin Shapoori, Fereidoun Azizi, Farhad Hosseinpanah
AIM: We aimed to compare the effectiveness and safety of sleeve gastrectomy versus gastric bypass at one-year. BACKGROUND: Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the two most commonly performed bariatric procedures worldwide. METHODS: Patients from a prospectively collected database who presented to a specialized bariatric center and underwent a primary bariatric procedure between March 2013 and April 2015 were included and compared regarding major and minor complication rates and weight loss parameters at 6 and 12 months...
December 2016: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/28207588/relationship-between-central-obesity-and-spread-of-spinal-anesthesia-in-female-patients
#14
Jee-Eun Chang, Hyerim Kim, Jung-Hee Ryu, Jung-Man Lee, Jin-Young Hwang
Central obesity may be related to the spread of spinal anesthesia in female patients. Fifty-seven female patients undergoing spinal anesthesia were allocated to either the central obesity or noncentral obesity group. After induction of spinal anesthesia, maximal sensory blockade (primary outcome), time for maximal sensory block, maximum motor block, time to maximum motor block, time to L2 regression, and time to Bromage scale 0 were evaluated. Multiple linear regression analyses showed that maximal sensory blockade was related to central obesity (P = ...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28183582/use-of-ultrasound-for-spinal-anesthesia-in-a-super-morbidly-obese-patient
#15
Yasuhiro Morimoto, Yoichiro Ihara, Yoko Shimamoto, Hiroko Shiramoto
We report the application of ultrasound prescans for spinal anesthesia to morbid obesity patient. A 38-year-old woman with a body mass index (BMI) of 50 (weight: 110 kg; height: 148 cm) was scheduled to undergo pilonidal cyst resection at the bottom of the tailbone. Spinal anesthesia was selected for the procedure, because the patient's position during the surgery was prone and the patient had morbid obesity. To determine the spinal needle insertion point and the distance between the skin and dura, we planned to use ultrasound...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28144270/a-clinical-trial-evaluating-the-laryngeal-mask-airway-supreme-in-obese-children-during-general-anesthesia
#16
Yue Tian, Xiu-Ying Wu, Lu Li, Ling Ma, Yun-Feng Li
INTRODUCTION: The laryngeal mask airway (LMA)-Supreme is a disposable double-lumen laryngeal mask airway that is widely used in clinical practice. However, its use in obese children has not been evaluated. The aim of this study was to determine whether the LMA-Supreme could perform equally as well as endotracheal intubation in obese children having a minor surgical procedure. MATERIAL AND METHODS: After ethical board approval, 100 obese male children receiving non-emergent appendectomy for chronic appendicitis or surgery to correct concealed penis were randomly divided into an endotracheal intubation group and an LMA-Supreme group...
February 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28128660/cardiac-failure-in-a-trisomy-9-patient-undergoing-anesthesia-a-case-report
#17
Cara J Riley, Timothy Moore, Lauren Eagelston, Dale Burkett, Scott Auerbach, Richard J Ing
A 27-year-old female with Trisomy 9 mosaicism presented to Children's Hospital Colorado for outpatient dental surgery under general anesthesia. The patient's past medical history was also significant for premature birth, gastroesophageal reflux, scoliosis and kyphosis, obesity, and developmental delay. Per her mother's report, the patient had no cardiac issues. She had undergone multiple previous general anesthetics, some of which documented respiratory complications such as laryngospasm, bronchospasm, and possible aspiration...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28121644/peripartum-management-of-obstructive-sleep-apnea
#18
Jessica M Booth, Ashley M Tonidandel
The prevalence of obstructive sleep apnea is unknown during pregnancy, but the syndrome is likely underdiagnosed and rising in frequency along with the obesity epidemic. Obstructive sleep apnea is associated with adverse outcomes, including hypertensive disorders of pregnancy, gestational diabetes, preterm, and cesarean delivery. Obese pregnant women should be screened and referred to a sleep medicine specialist for evaluation. Continuous positive airway pressure is the treatment of choice with demonstrated safety and compliance in pregnancy...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28099786/labor-intervention-and-outcomes-in-women-who-are-nulliparous-and-obese-comparison-of-nurse-midwife-to-obstetrician-intrapartum-care
#19
Nicole S Carlson, Elizabeth J Corwin, Nancy K Lowe
BACKGROUND: Women who are obese have slower labors than women of normal weight, and show reduced response to interventions designed to speed labor progress like oxytocin augmentation and artificial rupture of membranes. The optimal labor management for these women has not been described. METHODS: This retrospective cohort study compared 2 propensity score-matched groups of women (N = 360) who were healthy, nulliparous, spontaneously laboring, and obese (body mass index ≥ 30 kg/m(2) )...
January 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28079580/a-predictive-model-for-extended-postanesthesia-care-unit-length-of-stay-in-outpatient-surgeries
#20
Rodney A Gabriel, Ruth S Waterman, Jihoon Kim, Lucila Ohno-Machado
BACKGROUND: A predictive model that can identify patients who are at an increased risk for prolonged postanesthesia care unit (PACU) stay could help optimize resource utilization and case sequencing. Although previous studies identified some predictors, there is not a model that only utilizes various patients demographic and comorbidities, that are already known preoperatively, and that may affect PACU length of stay for outpatient procedures requiring the care of an anesthesiologist...
May 2017: Anesthesia and Analgesia
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