Faculty Collaboration Database

Perioperative considerations for patients with morbid obesity. Anesthesiol Clin 2006 Sep;24(3):621-36

Date

01/24/2007

Pubmed ID

17240609

DOI

10.1016/j.atc.2006.05.003

Scopus ID

2-s2.0-33748946629 (requires institutional sign-in at Scopus site)   33 Citations

Abstract

The anesthetic management of the MO patient requires an important focus on a number of issues beginning with a careful preoperative evaluation and synthesizing pre-existing disease processes with the anesthetic management plan. The common misperception that all MO patients are "full stomach" has been challenged and may be a nonissue. New approaches to pre-oxygenation to lessen the likelihood of desaturation during apnea may be a valuable tool if difficulty is encountered in tracheal intubation. In addition, promising results have been demonstrated with the use of the ILMA for ventilation and for blindly establishing tracheal tube placement. Proper patient positioning is essential to aid in successful intubation when a laryngoscope is employed. Intraoperative anesthetic management can be guided with a processed electroencephalogram monitor to help improve emergence and to enhance wakefulness in the PACU. Careful consideration must be given to postoperative analgesic needs by minimizing the use of opioids and employing nonopioid analgesics including NSAIDs, alpha2-adrenergic agonists, and low doses of ketamine.

Author List

Ebert TJ, Shankar H, Haake RM

Authors

Thomas J. Ebert MD Adjunct Professor in the Anesthesiology department at Medical College of Wisconsin
Hariharan Shankar MBBS Professor in the Anesthesiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Anesthesia, General
Anesthesia, Inhalation
Anesthetics, Intravenous
Humans
Intubation, Intratracheal
Neuromuscular Nondepolarizing Agents
Obesity, Morbid
Oxygen Inhalation Therapy
Perioperative Care
Posture
Propofol
Respiratory Aspiration