Anesthetic Management of Morbidly Obese and Super-Morbidly Obese Patients Undergoing Bariatric Operations: Hospital Course and Outcomes |
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Authors: | Yigal Leykin MD MSc Tommaso Pellis MD Eric Del Mestro Bernardo Marzano MD Giovanni Fanti MD Jay B Brodsky MD |
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Institution: | (1) Department of Anesthesia, Pain, Perioperative Medicine and Intensive Care, Santa Maria degli Angeli Hospital, Pordenone, Italy;(2) Department of Anesthesia, Pain, Perioperative Medicine and Intensive Care, Santa Maria degli Angeli Hospital, Pordenone, Italy;(3) Department of Anesthesia, Pain, Perioperative Medicine and Intensive Care, Santa Maria degli Angeli Hospital, Pordenone, Italy;(4) Department of Surgery, Santa Maria degli Angeli Hospital, Pordenone, Italy;(5) Department of Surgery, Santa Maria degli Angeli Hospital, Pordenone, Italy;(6) Department of Anesthesia, Stanford University Medical Center, Stanford, CA, USA |
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Abstract: | Background: Although the implications for the anesthetic and perioperative care of severely obese patients undergoing weight
loss operations are considerable, current anesthetic management of super-obese (SO) patients (BMI ≥50 kg/m2), including super-super-obese (BMI ≥60) derives from experience with morbidly obese (MO) patients (BMI 40-49.9 kg/m2). We compared anesthetic and perioperative data of SO patients and MO patients undergoing weight loss operations to evaluate
if anesthetic management influenced outcome. Methods: A retrospective analysis was performed on data from 150 consecutive
patients (119 MO, 31 SO) undergoing bariatric surgery between May 2000 and March 2005. Data analyzed included preoperative
anesthetic assessment, anesthetic management, postoperative care, and intra- or postoperative complications. Results: There
were no differences in anesthetic management or in postoperative course or outcome between MO and SO patients. Intraoperative
surgical complications occurred in 26% (n=8) in the SO group and 14% (n=15) in the MO group (P<0.01). Conclusions: No differences in outcome occurred between MO and SO patients undergoing bariatric operations under similar
anesthetic management. Anesthesia for weight loss surgery can be safely performed on SO patients with the understanding that
these patients are not at risk per se due to their higher BMI. The degree of obesity influenced only the incidence of intraoperative surgical complications. |
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Keywords: | OBESITY MORBID OBESITY SUPER-OBESITY ANESTHESIA: PERIOPERATIVE MANAGEMENT COMPLICATIONS |
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