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anesthesia and morbid obesity

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https://www.readbyqxmd.com/read/27916062/-perioperational-management-of-gynecological-cancer-patients-with-severe-internal-medical-complications-a-serial-of-37-clinical-cases
#1
J Hu, W Q Lyu, Y L Guo, H W Wen, H Qiao, Y Qu
Objective: To evaluate the effectiveness and safety of perioperational management of gynecological cancer patients with severe internal medical complications. Methods: We collected 37 cases of gynecological cancer patients with severe internal medical complications who were hospitalized in Peking University First Hospital from Jan. 2010 to Nov. 2014. All of the cases were planned to move to ICU right after operation based on the preoperational assessment of anesthetist and physician. The median age was 69.4 years, and 25 cases (68%,25/37) of them were over 70 years old...
November 25, 2016: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/27906717/spectrum-of-postoperative-complications-in-pulmonary-hypertension-and-obesity-hypoventilation-syndrome
#2
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/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/27871572/the-effects-of-sevoflurane-and-desflurane-on-the-hemodynamics-and-respiratory-functions-in-laparoscopic-sleeve-gastrectomy
#4
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/27870737/the-influence-of-body-mass-index-on-sensorimotor-block-and-vasopressor-requirement-during-spinal-anesthesia-for-elective-cesarean-delivery
#5
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
#6
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
#7
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
#8
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/27679950/robotic-assisted-modified-retroauricular-cervical-approach-initial-experience-in-latin-america
#9
Thiago Celestino Chulam, Renan Bezerra Lira, Luiz Paulo Kowalski
OBJECTIVE: to evaluate the thickness of the gastric wall at the time of intra gastric balloon (IGB) placement, at the time of its withdrawal and one month after withdrawal. METHODS: fifteen morbidly obese patients underwent the introduction of IGB under general anesthesia. In all patients, there was infusion of 500ml of distilled water in the balloon for the test. Measurements of the thickness of the gastric wall were made in the antrum, body and proximal body, using a radial echoendoscope with a frequency of 12MHz and maximum zoom, and its own balloon inflated with 5ml of distilled water...
July 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/27679949/gastric-wall-changes-after-intragastric-balloon-placement-a-preliminary-experience
#10
Luís Gustavo Santos Périssé, Paulo Cézar Marques Périssé Ecbc-Rj, Kelson Ferreira Ribeiro
OBJECTIVE: : to evaluate the thickness of the gastric wall at the time of intra gastric balloon (IGB) placement, at the time of its withdrawal and one month after withdrawal. METHODS: : fifteen morbidly obese patients underwent the introduction of IGB under general anesthesia. In all patients, there was infusion of 500ml of distilled water in the balloon for the test. Measurements of the thickness of the gastric wall were made in the antrum, body and proximal body, using a radial echoendoscope with a frequency of 12MHz and maximum zoom, and its own balloon inflated with 5ml of distilled water...
July 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/27651131/the-effect-of-perioperative-insulin-treatment-on-cardiodepression-in-mild-adiposity-in-mice
#11
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/27581114/gluteal-compartment-syndrome-following-abdominal-aortic-aneurysm-treatment-case-report-and-review-of-the-literature
#12
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/27574464/managing-anesthesia-for-cesarean-section-in-obese-patients-current-perspectives
#13
REVIEW
Agnes M Lamon, Ashraf S Habib
Obesity is a worldwide epidemic. It is associated with increased comorbidities and increased maternal, fetal, and neonatal complications. The risk of cesarean delivery is also increased in obese parturients. Anesthetic management of the obese parturient is challenging and requires adequate planning. Therefore, those patients should be referred to antenatal anesthetic consultation. Anesthesia-related complications and maternal mortality are increased in this patient population. The risk of difficult intubation is increased in obese patients...
2016: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/27513968/anesthetic-management-for-cesarean-delivery-in-a-patient-with-pulmonary-emboli-pulmonary-hypertension-and-right-ventricular-failure
#14
Shaun Patel, Krystal L Weierstahl, Sonalee Shah, Christina W Fidkowski
The maternal mortality rate for parturients with severe pulmonary hypertension is 30% to 50%. General, epidural, and combined low-dose spinal-epidural anesthesia have been used successfully for cesarean deliveries in patients with pulmonary hypertension. We describe a cesarean delivery performed using an intrathecal catheter in a 25-year-old morbidly obese (body mass index, 82 kg/m) woman (gravida 3, para 2 at 32 weeks of gestation) who had severe pulmonary hypertension, right ventricular failure, pulmonary emboli, and obstructive sleep apnea...
October 1, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27429939/oral-surgery-under-local-anesthesia-with-dexmedetomidine-sedation-in-a-morbidly-obese-patient-with-aortic-dissection
#15
Mika Seto, Michitaka Matsuda, Kyoichi Narihira, Toshihiro Kikuta
We report a case of a morbidly obese man with an aortic aneurysm, in whom dental surgery was performed before elective cardiac surgery. His aortic aneurysm required emergency surgery. However, because of his morbid obesity, elective cardiac surgery was planned. Considering the high risk of infective endocarditis, dental surgery was required. Our patient was at a high risk of aortic rupture caused by hypertension and breathing difficulty in the supine position. Dexmedetomidine (DEX) is an anti-anxiety, sedative, and analgesic medicine that can stabilize circulatory dynamics and minimize blood pressure fluctuations...
June 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/27382824/patient-ventilation-asynchrony-causing-negative-pressure-pulmonary-edema-in-an-intubated-obese-patient
#16
Sahar M Siddik-Sayyid, Waseem AlFahel, Mohamad F El-Khatib
Negative pressure pulmonary edema is a potentially life-threatening condition that may occur when a large negative intrathoracic pressure is generated against a 'physically' obstructed upper airway during emergence from anesthesia. We report a 35 year old male patient who is morbidly obese and undergoing laparoscopic gastric bypass who developed negative pressure pulmonary edema without any evidence of a 'physical' upper airway obstruction. In our patient, the negative pressure pulmonary edema occurred after complete reversal of neuromuscular blockade and during manual positive pressure ventilation with the endotracheal tube still in place and in the presence of an oral airway...
February 2016: Middle East Journal of Anesthesiology
https://www.readbyqxmd.com/read/27343794/perioperative-management-of-a-morbidly-obese-pregnant-patient-undergoing-cesarean-section-under-general-anesthesia-case-report
#17
Márcio Luiz Benevides, Verônica Cristina Moraes Brandão, Jacqueline Ivonne Arenas Lovera
BACKGROUND AND OBJECTIVES: The increased prevalence of obesity in the general population extends to women of reproductive age. The aim of this study is to report the perioperative management of a morbidly obese pregnant woman, body mass index >50kg/m(2), who underwent cesarean section under general anesthesia. CASE REPORT: Pregnant woman in labor, 35 years of age, body mass index 59.8kg/m(2). Cesarean section was indicated due to the presumed fetal macrosomia...
July 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27140684/the-myth-of-rescue-reversal-in-can-t-intubate-can-t-ventilate-scenarios
#18
Mohamed Naguib, Lara Brewer, Cristen LaPierre, Aaron F Kopman, Ken B Johnson
BACKGROUND: An unanticipated difficult airway during induction of anesthesia can be a vexing problem. In the setting of can't intubate, can't ventilate (CICV), rapid recovery of spontaneous ventilation is a reasonable goal. The urgency of restoring ventilation is a function of how quickly a patient's hemoglobin oxygen saturation decreases versus how much time is required for the effects of induction drugs to dissipate, namely the duration of unresponsiveness, ventilatory depression, and neuromuscular blockade...
July 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27101501/perioperative-respiratory-adverse-events-in-pediatric-ambulatory-anesthesia-development-and-validation-of-a-risk-prediction-tool
#19
Rajeev Subramanyam, Samrat Yeramaneni, Mohamed Monir Hossain, Amy M Anneken, Anna M Varughese
BACKGROUND: Perioperative respiratory adverse events (PRAEs) are the most common cause of serious adverse events in children receiving anesthesia. Our primary aim of this study was to develop and validate a risk prediction tool for the occurrence of PRAE from the onset of anesthesia induction until discharge from the postanesthesia care unit in children younger than 18 years undergoing elective ambulatory anesthesia for surgery and radiology. The incidence of PRAE was studied. METHODS: We analyzed data from 19,059 patients from our department's quality improvement database...
May 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27100522/the-relationship-between-rostral-retraction-of-the-pannus-and-outcomes-at-cesarean-section
#20
Ozhan M Turan, Joshua Rosenbloom, Jessica L Galey, Stephanie L Kahntroff, Shobana Bharadwaj, Shafonya M Turner, Andrew M Malinow
Objective Maternal obesity presents several challenges at cesarean section. In an effort to routinely employ a transverse suprapubic skin incision, we often retract the pannus in a rostral direction using adhesive tape placed after induction of anesthesia and before surgical preparation of the skin. We sought to understand the association between taping and neonatal cord blood gases, Apgar scores, and time from skin incision to delivery of the neonate. Study Design This is a retrospective study, performed using prospectively collected anesthesiology records with data supplemented from the patients' medical records...
August 2016: American Journal of Perinatology
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