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Obesity surgery and anesthesia

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https://www.readbyqxmd.com/read/27906717/spectrum-of-postoperative-complications-in-pulmonary-hypertension-and-obesity-hypoventilation-syndrome
#1
Roop K Kaw
PURPOSE OF REVIEW: The purpose of this review is to identify chronic pulmonary conditions which may often not be recognized preoperatively especially before elective noncardiac surgery and which carry the highest risk of perioperative morbidity and mortality. RECENT FINDINGS: This review discusses some of the most recent studies that highlight the perioperative complications, and their prevention and management strategies. SUMMARY: Pulmonary hypertension is a well recognized risk factor for postoperative complications after cardiac surgery but the literature surrounding noncardiac surgery is sparse...
November 30, 2016: Current Opinion in Anaesthesiology
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
#2
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
#3
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...
November 24, 2016: Obesity Surgery
https://www.readbyqxmd.com/read/27875102/obesity-increases-operative-time-in-children-undergoing-laparoscopic-cholecystectomy
#4
T K Pandian, Daniel S Ubl, Elizabeth B Habermann, Christopher R Moir, Michael B Ishitani
INTRODUCTION: Few studies have assessed the impact of obesity on laparoscopic cholecystectomy (LC) in pediatric patients. MATERIALS AND METHODS: Children who underwent LC were identified from the 2012 to 2013 American College of Surgeons' National Surgical Quality Improvement Program Pediatrics data. Patient characteristics, operative details, and outcomes were compared. Multivariable logistic regression was utilized to identify predictors of increased operative time (OT) and duration of anesthesia (DOAn)...
November 22, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27871572/the-effects-of-sevoflurane-and-desflurane-on-the-hemodynamics-and-respiratory-functions-in-laparoscopic-sleeve-gastrectomy
#5
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/27871524/predictors-of-desaturation-during-patient-transport-to-the-postoperative-anesthesia-care-unit-an-observational-study
#6
François Labaste, Stein Silva, Léa Serin-Moulin, Etienne Lefèvre, Bernard Georges, Jean-Marie Conil, Vincent Minville
BACKGROUND: The transport of postoperative patients to the postoperative anesthesia care unit (PACU) is a high-risk period for hypoxemia. The aim of this study was to determine risk factors for hypoxemia during transfers to the PACU. METHODS: An observational, prospective, monocentric, and noninterventional study was conducted in the University Hospital of Toulouse in 2015 during a 5-week period. All patients who were transferred to PACU were included. Twenty-eight variables related to patient, surgery, and anesthesia were recorded...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870737/the-influence-of-body-mass-index-on-sensorimotor-block-and-vasopressor-requirement-during-spinal-anesthesia-for-elective-cesarean-delivery
#7
T C Ngaka, J F Coetzee, R A Dyer
BACKGROUND: It has been suggested that the dose requirement for spinal anesthesia (SA) is lower in obese patients for cesarean delivery (CD). In this prospective, observational, noninferiority study, we tested the hypothesis that obesity would not have a clinically important effect on vasopressor requirements or block height. METHODS: Two groups of 25 parturients, group O (body mass index [BMI] >40 kg/m) and group N (BMI <32 kg/m) requiring elective CD were recruited...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27777205/-pharmacokinetics-of-a-cisatracurium-dose-according-to-fat-free-mass-for-anesthesia-induction-in-morbidly-obese-patients
#8
Jia-Yang Li, Qi-Rong Zou, Xue-Mei Peng
OBJECTIVE: To compare the pharmacokinetics of cisatracurium between normal weight patients and morbidly obese patients. METHODS: Twelve obese ASA I-II patients (BMI≥35 kg/m(2)) undergoing laparoscopic Roux-en-Y gastric bypass and 12 normal weight ASA I-II patients (BMI of 18.5-24 kg/m(2)) undergoing laparoscopic surgery were enrolled. The obese patients were given a cisatracurium dose of 0.15 mg/kg according to the fat-free mass (FFM), and the non-obese patients received a dose of 0...
October 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27759743/perioperative-and-periprocedural-airway-management-and-respiratory-safety-for-the-obese-patient-2016-siaarti-consensus
#9
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 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...
October 19, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27726001/-perioperative-adverse-respiratory-events-in-overweight-and-obese-children
#10
J Ulrici, G Hempel, M Sasse, J Vollrath, C Höhne
BACKGROUND: Overweight and obesity are increasing problems in pediatric anesthesia. This observational study was designed to examine how airway-related complications occur in overweight children and adolescents during general anesthesia and if this is a relevant problem in Germany. METHODS: From October 2008 until August 2009, at the university clinic in Leipzig, 504 in- and outpatients, aged 2-18 years, ASA I-III, undergoing elective procedures (ENT and pediatric surgery), were observed...
October 10, 2016: Der Anaesthesist
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
#11
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/27687394/the-optimal-combination-of-mechanical-ventilator-parameters-under-general-anesthesia-in-obese-patients-undergoing-laparoscopic-surgery
#12
Pengcheng Xie, Zhanfang Li, Zhongyi Tian
OBJECTIVE: Pulmonary dysfunction after laparoscopic surgery is commonly seen in the high-risk group of obese patients. To reduce or avoid this complication caused by an improper combination of mechanical ventilation parameters, we conducted the following trial of 3 factors with 3 levels of mechanical ventilation, aimed to obtain the low airway pressure with good ventilator effects. METHODS: Patients were randomly allocated as a sample of cases according to the "30≤weight/height(2)<40" obesity index...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27687316/-effect-of-equipotent-doses-of-bupivacaine-and-ropivacaine-in-high-fat-diet-fed-neonatal-rodent-model
#13
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...
September 26, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27651131/the-effect-of-perioperative-insulin-treatment-on-cardiodepression-in-mild-adiposity-in-mice
#14
Chantal A Boly, Etto C Eringa, R Arthur Bouwman, Rob F P van den Akker, Frances S de Man, Ingrid Schalij, Stephan A Loer, Christa Boer, Charissa E van den Brom
BACKGROUND: While most studies focus on cardiovascular morbidity following anesthesia and surgery in excessive obesity, it is unknown whether these intraoperative cardiovascular alterations also occur in milder forms of adiposity without type 2 diabetes and if insulin is a possible treatment to improve intraoperative myocardial performance. In this experimental study we investigated whether mild adiposity without metabolic alterations is already associated with cardiometabolic dysfunction during anesthesia, mechanical ventilation and surgery and whether these myocardial alterations can be neutralized by intraoperative insulin treatment...
2016: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/27647792/risk-factors-for-cognitive-impairment-in-fragile-x-associated-tremor-ataxia-syndrome
#15
Andreea L Seritan, Kyoungmi Kim, Ian Benjamin, Ioana Seritan, Randi J Hagerman
Fragile X-associated tremor/ataxia syndrome (FXTAS) is a late-onset neurodegenerative disease with motor, psychiatric, and cognitive manifestations that occurs in carriers of the fragile X mental retardation 1 (FMR1) gene premutations. This was a retrospective chart review of 196 individuals (127 men and 69 women) with FXTAS. Forty-six (23%) participants were cognitively impaired, of whom 19 (10%) had dementia. Risk factors for dementia were examined (CGG repeat size; alcohol, benzodiazepine, and opioid use; diabetes; hyperlipidemia; hypertension; hypothyroidism; obesity; sleep apnea; surgeries with general anesthesia; depression; family history of dementia)...
September 19, 2016: Journal of Geriatric Psychiatry and Neurology
https://www.readbyqxmd.com/read/27608746/innovative-multi-modal-physical-therapy-reduces-incidence-of-manipulation-under-anesthesia-mua-in-non-obese-primary-total-knee-arthroplasty
#16
Tanner McGinn, Morad Chughtai, Anil Bhave, Osman Ali, Prathik Mudaliar, Anton Khlopas, Steven F Harwin, Michael A Mont
INTRODUCTION: Patients may experience knee stiffness following total knee arthroplasty (TKA). Non-operative measures, such as more physical therapy and special splints are warranted in such cases. In the event of failure of these measures to restore knee range of motion, more invasive procedures with higher risks, such as manipulation under anesthesia (MUA) or repeat surgery, can be utilized. Thus, it becomes essential to optimize their non-operative measures in order to avoid more invasive, riskier options...
September 10, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27581114/gluteal-compartment-syndrome-following-abdominal-aortic-aneurysm-treatment-case-report-and-review-of-the-literature
#17
Emanuela Viviani, Anna Maria Giribono, Donatella Narese, Doriana Ferrara, Giuseppe Servillo, Luca Del Guercio, Umberto Marcello Bracale
Compartment syndrome (CS) is a pathological increase of the interstitial pressure within the closed osseous fascial compartments. Trauma is the most common cause, followed by embolization, burns, and iatrogenic injuries; it usually involves the limbs. The major issue when dealing with CS is the possibility to do an early diagnosis in order to intervene precociously, through a fasciotomy, reducing the risk of tissue, vascular and nervous damage. Although it is an infrequent condition, it is potentially life threatening...
August 31, 2016: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/27555141/increasing-body-mass-index-and-the-incidence-of-intraoperative-hypoxemia
#18
Samir M Kendale, Jeanna D Blitz
STUDY OBJECTIVE: Obese patients regularly present for surgery and have greater hypoxemia risk. This study aimed to identify the risk and incidence of intraoperative hypoxemia with increasing body mass index (BMI). DESIGN: This was a retrospective cohort study. SETTING: Operating room. PATIENTS: A total of 15,238 adult patients who underwent general anesthesia for elective noncardiac surgery at a single large urban academic institution between January 2013 and December 2014...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27543009/higher-body-mass-index-associated-with-severe-early-childhood-caries
#19
Katherine Davidson, Robert J Schroth, Jeremy A Levi, Aaron B Yaffe, Betty-Anne Mittermuller, Elizabeth A C Sellers
BACKGROUND: Severe Early Childhood Caries (S-ECC) is an aggressive form of tooth decay in preschool children affecting quality of life and nutritional status. The purpose was to determine whether there is an association between Body Mass Index (BMI) and S-ECC. METHODS: Children with S-ECC were recruited on the day of their slated dental surgery under general anesthesia. Age-matched, caries-free controls were recruited from the community. All children were participating in a larger study on nutrition and S-ECC...
2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27449691/computed-tomography-morphometrics-and-pulmonary-intolerance-in-endometrial-cancer-robotic-surgery
#20
Ahmed Y Abdelbadee, Raj M Paspulati, Heather D McFarland, Mohamed A Bedaiwy, Leslie Ciancibello, Gina Anderson, Kristine M Zanotti
STUDY OBJECTIVES: To identify morphometric characteristics of obese patients that best predict pulmonary intolerance to robotic pelvic surgery using a novel method for quantifying adipose distribution. DESIGN: Retrospective study (Canadian Task Force classification II-2). SETTING: University hospital. PATIENTS: Fifty-nine patients with endometrial cancer who underwent robotic hysterectomy and lymphadenectomy between April 2008 and May 2014 and also underwent perioperative computed tomography (CT) imaging within 1 year...
July 20, 2016: Journal of Minimally Invasive Gynecology
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