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Bariatric Anesthesia

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https://www.readbyqxmd.com/read/28489210/sugammadex-ed90-dose-to-reverse-the-rocuronium-neuromuscular-blockade-in-obese-patients
#1
Mauro Prado DA Silva, Christiano Matsui, Daniel Dongiou Kim, Joaquim Edson Vieira, Carlos Alberto Malheiros, Ligia Andrade Silva Telles Mathias
Objective: to determine the ED90 (minimum effective dose in 90% of patients) of sugammadex for the reversal of rocuronium-induced moderate neuromuscular blockade (NMB) in patients with grade III obesity undergoing bariatric surgery. Methods: we conducted a prospective study with the biased coin up-and-down sequential design. We chosen the following doses: 2.0mg/Kg, 2.2mg/Kg, 2.4mg/Kg, 2.6mg/Kg, 2.8mg/Kg. The complete reversal of rocuronium-induced NMB considered a T4/T1 ratio ≥0...
January 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28489162/endoscopic-sleeve-gastroplasty-for-obesity-treatment-two-years-of-experience
#2
Gontrand Lopez-Nava, M P Galvão, I Bautista-Castaño, J P Fernandez-Corbelle, M Trell, N Lopez
Background: Bariatric endoscopic techniques are minimally invasive and induce gastric volume reduction to treat obesity. Aim : To evaluate endoscopic sleeve gastroplasty (Apollo method) using a suturing method directed at the greater curvature, as well as the perioperative care, two year safety and weight loss. Method: Prospective single-center study over 154 patients (108 females) using the endoscopic sleeve gastroplasty procedure under general anesthesia with overnight inpatient observation...
January 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/28482650/obesity-and-perioperative-noninvasive-ventilation-in-bariatric-surgery
#3
Michele Carron, Francesco Zarantonello, Giovanna Ieppariello, Carlo Ori
The incidence and prevalence of obesity continues to increase globally. Physicians will therefore provide care for an increasing number of obese patients in their clinical practice. Optimal management of these patients is required to minimize the risk of perioperative complications that increase morbidity and mortality. Obesity affects the respiratory function. It is generally associated with reduced lung volume with increased atelectasis, decreased lung and chest wall compliance, increased airway resistance, and moderate to severe hypoxemia...
June 2017: Minerva Chirurgica
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
#4
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/28238111/use-of-fentanyl-in-adolescents-with-clinically-severe-obesity-undergoing-bariatric-surgery-a-pilot-study
#5
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...
June 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28224030/safety-and-effectiveness-of-sleeve-gastrectomy-versus-gastric-bypass-one-year-results-of-tehran-obesity-treatment-study-tots
#6
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/28223876/evaluation-of-the-impact-of-a-prescribing-guideline-on-the-use-of-intraoperative-dexmedetomidine-at-a-tertiary-academic-medical-center
#7
Abdullah M Alhammad, Nour A Baghdady, Rachel A Mullin, Bonnie C Greenwood
Objective: To evaluate usage patterns of dexmedetomidine in the operating room after implementation of a prescribing guideline. Methods: We conducted a retrospective analysis to evaluate the impact of a prescribing guideline on usage patterns of dexmedetomidine in the operating room at a tertiary, academic medical center during one-month period pre- (July 2010) and post-guideline (July 2011 and July 2012) implementation. Results: A total of 267 patients received intraoperative dexmedetomidine during the study period...
January 2017: Saudi Pharmaceutical Journal: SPJ: the Official Publication of the Saudi Pharmaceutical Society
https://www.readbyqxmd.com/read/28107276/the-effect-of-deep-versus-moderate-neuromuscular-block-on-surgical-conditions-and-postoperative-respiratory-function-in-bariatric-laparoscopic-surgery-a-randomized-double-blind-clinical-trial
#8
Sam Baete, Gerd Vercruysse, Margot Vander Laenen, Pieter De Vooght, Jeroen Van Melkebeek, Dimitri Dylst, Maud Beran, Jan Van Zundert, René Heylen, Willem Boer, Sam Van Boxstael, Tom Fret, Hans Verhelst, Cathy De Deyne, Frank Jans, Pascal Vanelderen
BACKGROUND: In recent literature, it has been suggested that deep neuromuscular block (NMB) improves surgical conditions during laparoscopy; however, the evidence supporting this statement is limited, and this was not investigated in laparoscopic bariatric surgery. Moreover, residual NMB could impair postoperative respiratory function. We tested the hypotheses that deep NMB could improve the quality of surgical conditions for laparoscopic bariatric surgery compared with moderate NMB and investigated whether deep NMB puts patients at risk for postoperative respiratory impairment compared with moderate NMB...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27979371/melatonin-premedication-improves-quality-of-recovery-following-bariatric-surgery-a-double-blind-placebo-controlled-prospective-study
#9
Michal Ivry, Goitein David, Welly Wiam, Berkenstadt Haim
BACKGROUND: Melatonin has hypnotic, sedative, analgesic, anti-inflammatory, and antioxidant properties, and is a widely used sleep agent. OBJECTIVES: Our aim was to evaluate the effect of melatonin premedication on postoperative recovery in patients undergoing bariatric surgery. SETTING: University Hospital, Israel. METHODS: Patients undergoing bariatric surgery were randomized to receive either 5 mg melatonin (M group) or placebo (P group) once on the night before surgery and again 2 hours before surgery...
March 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27900560/serum-leptin-obestatin-and-ghrelin-levels-and-gastric-emptying-rates-of-liquid-and-solid-meals-in-non-obese-rats-with-roux-en-y-bypass-surgery-or-prosthesis-placement-implications-for-the-role-of-vagal-afferents
#10
Yunus Yavuz, Zarife Nigar Özdemir Kumral, Gülsün Memi, Özge Dağdeviren Çevik, Cumhur Yeğen, Berrak Ç Yeğen
BACKGROUND: The present study aimed to investigate the effects of Roux-en-Y gastric bypass (RYGB) and prosthesis placement on gastric emptying rate in conjunction with serum ghrelin-obestatin-leptin responses in non-obese rats with intact or denervated afferent innervation. METHODS: Under anesthesia, male Sprague-Dawley rats underwent either sham operation, RYGB, prosthesis, and/or Gregory cannula placement. Three weeks later, liquid or solid gastric emptying tests were performed and serum ghrelin, leptin and obestatin levels were measured...
November 29, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27885537/safety-analysis-of-bariatric-patients-undergoing-outpatient-upper-endoscopy-with-non-anesthesia-administered-propofol-sedation
#11
Tyler McVay, John C Fang, Linda Taylor, Alexander Au, Wesley Williams, Angela P Presson, Ragheed Al-Dulaimi, Eric Volckmann, Anna Ibele
BACKGROUND: Non-anesthesia administered propofol (NAAP) has been shown to be a safe and effective method of sedation for patients undergoing gastrointestinal endoscopy. Bariatric surgery patients are potentially at a higher risk for sedation-related complications due to co-morbidities including obstructive sleep apnea. The outcomes of NAAP in bariatric patients have not been previously reported. METHODS: In this retrospective cohort study, severely obese patients undergoing pre-surgical outpatient esophagogastroduodenoscopy (EGD) were compared to non-obese control patients (BMI ≤ 25 kg/m(2)) undergoing diagnostic EGD at our institution from March 2011-September 2015 using our endoscopy database...
June 2017: Obesity Surgery
https://www.readbyqxmd.com/read/27871572/the-effects-of-sevoflurane-and-desflurane-on-the-hemodynamics-and-respiratory-functions-in-laparoscopic-sleeve-gastrectomy
#12
Hatice Kaya Ozdogan, Suleyman Cetinkunar, Faruk Karateke, Sibel Cetinalp, Muge Celik, Sefa Ozyazici
STUDY OBJECTIVES: Sleeve gastrectomy has been one of the most commonly performed bariatric surgery methods. The study aimed to compare the effects of 2 most commonly used inhalation anesthetics, sevoflurane and desflurane, on the peroperative hemodynamic alterations and postoperative respiratory functions in morbidly obese patients undergoing sleeve gastrectomy. DESIGN: Nonrandomized cohort. SETTINGS: Operating room, postoperative period. PATIENTS: Eighty-four morbidly obese patients with a body mass index greater than 40 kg/m(2) who had scheduled to undergo sleeve gastrectomy operation were prospectively included in the study...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27759743/perioperative-and-periprocedural-airway-management-and-respiratory-safety-for-the-obese-patient-2016-siaarti-consensus
#13
Flavia Petrini, Ida Di Giacinto, Rita Cataldo, Clelia Esposito, Vittorio Pavoni, Paolo Donato, Antonella Trolio, Guido Merli, Massimiliano Sorbello, Paolo Pelosi
Proper management of obese patients requires a team vision and appropriate behaviors by all health care providers in hospital. Specialist competencies are fundamental, as are specific clinical pathways and good clinical practices designed to deal with patients whose Body Mass Index (BMI) is ≥30 kg/m2. Standards of care for bariatric and non-bariatric surgery and for the critical care management of this population exist but are not well defined nor clearly followed in every hospital. Thus every anesthesiologist is likely to deal with this challenging population...
December 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27687395/respiratory-volume-monitoring-in-an-obese-surgical-population-and-the-prediction-of-postoperative-respiratory-depression-by-the-stop-bang-osa-risk-score
#14
Roman Schumann, Andrzej P Kwater, Iwona Bonney, Diane Ladd, Julie Kim, Anupriya Gupta, Sam D Gumbert, Evan G Pivalizza
STUDY OBJECTIVE: To evaluate use of a respiratory volume monitor (RVM; ExSpiron, Respiratory Motion, Inc., Waltham, MA, USA) that provides minute ventilation (MV), tidal volume (TV) and respiratory rate (RR) measurements in obese surgical patients, hitherto undescribed. DESIGN: Prospective, IRB-approved observational study of RVM parameter accuracy in obese surgical patients, designed to test the ability of the RVM to detect predefined postoperative respiratory depression (PORD) and apneic events (POA) and to correlate STOP-Bang scores with PORD and POA...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27573514/does-body-mass-index-reduction-by-bariatric-surgery-affect-laryngoscopy-difficulty-during-subsequent-anesthesia
#15
Mordechai Shimonov, Pinhas Schechter, Mona Boaz, Ronen Waintrob, Tiberiu Ezri
BACKGROUND: The effect of body mass index (BMI) reduction following bariatric surgery on subsequent airway management has not been investigated. This study aimed to investigate the association between BMI reduction and airway assessment and management measured by Mallampati class (MC) and laryngoscopy grade (LG). METHODS: We conducted a retrospective study over 6 years to compare the BMI changes, MC and LG in patients having weight reduction bariatric surgery followed by subsequent surgery...
March 2017: Obesity Surgery
https://www.readbyqxmd.com/read/27556077/endoscopic-extraction-of-adjustable-gastric-bands-after-intragastric-migration-as-a-complication-of-bariatric-surgery-technique-and-advice
#16
David Collado-Pacheco, Luis Ramon Rábago-Torre, Maria Arias-Rivera, Alejandro Ortega-Carbonel, Ana Olivares-Valles, Alicia Alonso-Prada, Jaime Vázquez-Echarri, Norberto Herrera-Merino
BACKGROUND: Surgery has been the method most widely used to manage the extraction of gastric bands with inclusion as a late complication of bariatric surgery; however, surgical extraction entails morbidity and limits future surgical procedures. The development of endoscopic techniques has provided an important means of improving the treatment of this complication, enabling minimally invasive and safe procedures that have a high success rate. METHODS: A retrospective analysis was conducted of patients who had laparoscopic gastric banding complicated by intragastric migration and were treated endoscopically...
June 2016: Endoscopy International Open
https://www.readbyqxmd.com/read/27339370/circular-abdominoplasty-after-massive-weight-loss-is-it-a-risky-procedure
#17
Ali Modarressi, Eva Meia Rüegg, Thierry Bezzola, Brigitte Pittet-Cuénod
INTRODUCTION: Most post-bariatric patients seek body contouring procedures to correct skin excess after massive weight loss. Among these procedures, some surgeons are still wary of circular abdominoplasty, mainly because it is considered a major intervention associated with a high complication rate. The aim of this study was to assess the complication rate of circular abdominoplasty performed on patients presenting with massive weight loss, with a particular emphasis on patient selection and surgical technique...
November 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27272759/robotic-assisted-laparoscopic-radical-nephrectomy-using-the-da-vinci-si-system-how-to-improve-surgeon-autonomy-our-step-by-step-technique
#18
Hugo H Davila, Raul E Storey, Marc C Rose
Herein, we describe several steps to improve surgeon autonomy during a Left Robotic-Assisted Laparoscopic Radical Nephrectomy (RALRN), using the Da Vinci Si system. Our kidney cancer program is based on 2 community hospitals. We use the Da Vinci Si system. Access is obtained with the following trocars: Two 8 mm robotic, one 8 mm robotic, bariatric length (arm 3), 15 mm for the assistant and 12 mm for the camera. We use curved monopolar scissors in robotic arm 1, Bipolar Maryland in arm 2, Prograsp Forceps in arm 3, and we alternate throughout the surgery with EndoWrist clip appliers and the vessel sealer...
September 2016: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/27213116/a-large-animal-survival-model-to-evaluate-bariatric-surgery-mechanisms
#19
Vlad V Simianu, Jonathan G Sham, Andrew S Wright, Skye D Stewart, Mouhamad Alloosh, Michael Sturek, David E Cummings, David R Flum
BACKGROUND: The impact of Roux-en-Y gastric bypass (RYGB) on type 2 diabetes mellitus is thought to result from upper and/or lower gut hormone alterations. Evidence supporting these mechanisms is incomplete, in part because of limitations in relevant bariatric-surgery animal models, specifically the lack of naturally insulin-resistant large animals. With overfeeding, Ossabaw swine develop a robust metabolic syndrome, and may be suitable for studying post-surgical physiology. Whether bariatric surgery is feasible in these animals with acceptable survival is unknown...
August 2015: Surgical Science
https://www.readbyqxmd.com/read/27171827/continuous-positive-airway-pressure-mitigates-opioid-induced-worsening-of-sleep-disordered-breathing-early-after-bariatric-surgery
#20
RANDOMIZED CONTROLLED TRIAL
Sebastian Zaremba, Christina H Shin, Matthew M Hutter, Sanjana A Malviya, Stephanie D Grabitz, Teresa MacDonald, Daniel Diaz-Gil, Satya Krishna Ramachandran, Dean Hess, Atul Malhotra, Matthias Eikermann
BACKGROUND: Bariatric surgery patients are vulnerable to sleep-disordered breathing (SDB) early after recovery from surgery and anesthesia. The authors hypothesized that continuous positive airway pressure (CPAP) improves postoperative oxygenation and SDB and mitigates opioid-induced respiratory depression. METHODS: In a randomized crossover trial, patients after bariatric surgery received 30% oxygen in the postanesthesia care unit (PACU) under two conditions: atmospheric pressure and CPAP (8 to 10 cm H2O)...
July 2016: Anesthesiology
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