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Obezite cerrahisinde anestezi yönetimi: retrospektif çalışma

Year 2022, , 148 - 151, 15.10.2022
https://doi.org/10.53446/actamednicomedia.1168926

Abstract

Amaç: Retrospektif çalışmada hastanemizde laparoskopik bariatrik cerrahi uygulanan hastalardaki anestezi deneyimimizin aktarılması ve perioperatif yönetimin literatür eşliğinde tartışılması amaçlanmıştır.
Gereç ve Yöntem: Obezite cerrahisi geçiren ASA II-III olan 72 Hasta retrospektif olarak değerlendirilmiştir. Hastaların demografik özellikleri, cerrahi süresi, peroperatif dönemde görülen komplikasyonlar (akut kidney injury-AKI), yoğun bakım ihtiyacı kaydedilmiştir.
Bulgular: Hastaların havayolu yönetiminde 7 (%10,3) hastada zor maske ventilasyon, 11 (%16,2) hastada zor entübasyon olduğu değerlendirilmiştir. İntraoperatif dönemde görülen komplikasyonlar arasında bradikardi, hipotansiyon görülmüştür. Ortalama cerrahi süre 135 dakika, cerrahi bitiminde 4 hasta yoğun bakım ünitesinde 24saat takip edilmiştir. Bu hastaların 2’sinde obstrüktif uyku apnesi sendromu (OSAS) tanısı vardı. Hastaların postoperatif 24 saatlik takiplerinde 1 hastada (%1,5) Akut kıdney injury (AKI) gelişmiştir.
Sonuç: Laparaskopik obezite cerrahisinde oluşabilecek komplikasyonların önlenmesinde preoperatif hazırlık, uygun peroperatif sıvı yönetimi ideal anestezi için gereklidir.

References

  • 1.World Health Organization. Controlling the global obesity epidemic. 2018. http://www.who.int/nutrition/topics/obesity/en
  • 2.Europe W. 2019. Available at: http://www.euro.who.int/en/health-topics/diseaseprevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi. Accessed May 6, 2019.
  • 3. Ashish C. Sinha (Editor) Oxford Textbook of Anaesthesia for the Obese Patient. Oxford University Press. 2021. (Great Clarendon Street, Oxford, OX2 6DP, United Kingdom) DOI: 10.1093/med/9780198757146.001.0001
  • 4. Stenberg E, Dos Reis Falcão LF, O'Kane M, Liem R, Pournaras DJ, Salminen P, Urman RD, Wadhwa A, Gustafsson UO, Thorell A. Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update. World J Surg. 2022 Apr;46(4):729-751. doi: 10.1007/s00268-021-06394-9
  • 5. Collins JS, Lemmens HJ, Brodsky JB (2006) Obesity and difficult intubation: where is the evidence?. Anesthesiology, 104(3):617; author reply 618–619
  • 6. Lundstrøm LH, Møller AM, Rosenstock C, Astrup G, Wetterslev J. High body mass index is a weak predictor for difficult and failed tracheal intubation. Anesthesiology. 2009;110(2):266–74.
  • 7. Collins JS, Lemmens HJM, Brodsky JB, Brock-Utne JG, Levitan RM. Laryngoscopy and morbid obesity: a comparison of the ‘sniff’ and ‘ramped’ positions. Obes Surg. 2004;14(9):1171–75.
  • 8. Zvara DA, Calicott RW, Whelan DM. Positioning for intubation in morbidly obese patients. Anesth Analg. 2006;102(5):1592.
  • 9. De Jong A, Molinari N, Pouzeratte Y, et al. Difficult intubation in obese patients: incidence, risk factors, andcomplications in the operating theatre and in intensive care units. BJA. 2015; 114: 297-306.
  • 10. Gami AS, Caples SM, Somers VK. Obesity and obstructive sleep apnea. Endocrinol Metab Clin North Am. 2003;32(4):869–94.
  • 11. Valencia-Flores M, Orea A, Castaño VA, Resendiz M, Rosales M, Rebollar V, et al. Prevalence of sleep apnea and electrocardiographic disturbances in morbidly obese patients. Obes Res.2000;8(3):262–69.
  • 12. Tomi Pösö , Doris Kesek, Roman Aroch, Ola Winsö. Morbid obesity and optimization of preoperative fluid therapy. Obes Surg. 2013 Nov;23(11):1799-805. doi: 10.1007/s11695-013-0987-y.
  • 13. Messina A, Robba C, Calabrò L, Zambelli D, Iannuzzi F, Molinari E, Scarano S, Battaglini D, Baggiani M, De Mattei G, Saderi L, Sotgiu G, Pelosi P, Cecconi M. Perioperative liberal versus restrictive fluid strategies and postoperative outcomes: a systematic review and metanalysis on randomised-controlled trials in major abdominal elective surgery. Crit Care. 2021 Jun 11;25(1):205. doi: 10.1186/s13054-021-03629-y.
  • 14. Tolone S, Pilone V, Musella M, Rossetti G, Milone M, Fei L, Forestieri P, Docimo L. Rhabdomyolysis after bariatric surgery: a multicenter, prospective study on incidence, risk factors, and therapeutic strategy in a cohort from South Italy. Surg Obes Relat Dis. 2016 Feb;12(2):384-90. doi: 10.1016/j.soard.2015.11.005.
  • 15. Shen W, Wu Z, Wang Y, Sun Y, Wu A. Impact of Enhanced Recovery After Surgery (ERAS) protocol versus standard of care on postoperative Acute Kidney Injury (AKI): A meta-analysis. PLoS One. 2021 May 20;16(5):e0251476. doi: 10.1371/journal.pone.0251476.
  • 16. Romagnoli S, Zagli G, Tuccinardi G, Tofani L, Chelazzi C, et al. (2016) Postoperative acute kidney injury in high-risk patients undergoing major abdominal surgery. Journal of Critical Care 35: 120–125. https://doi.org/10.1016/j.jcrc.2016.05.012 PMID: 27481746
  • 17. O Connor ME, O Connor ME, Kirwan CJ, Kirwan CJ, Pearse RM, et al. (2016) Incidence and associations of acute kidney injury after major abdominal surgery. Intensive Care Medicine 42: 521–530. https://doi.org/10.1007/s00134-015-4157-7 PMID: 26602784
Year 2022, , 148 - 151, 15.10.2022
https://doi.org/10.53446/actamednicomedia.1168926

Abstract

References

  • 1.World Health Organization. Controlling the global obesity epidemic. 2018. http://www.who.int/nutrition/topics/obesity/en
  • 2.Europe W. 2019. Available at: http://www.euro.who.int/en/health-topics/diseaseprevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi. Accessed May 6, 2019.
  • 3. Ashish C. Sinha (Editor) Oxford Textbook of Anaesthesia for the Obese Patient. Oxford University Press. 2021. (Great Clarendon Street, Oxford, OX2 6DP, United Kingdom) DOI: 10.1093/med/9780198757146.001.0001
  • 4. Stenberg E, Dos Reis Falcão LF, O'Kane M, Liem R, Pournaras DJ, Salminen P, Urman RD, Wadhwa A, Gustafsson UO, Thorell A. Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update. World J Surg. 2022 Apr;46(4):729-751. doi: 10.1007/s00268-021-06394-9
  • 5. Collins JS, Lemmens HJ, Brodsky JB (2006) Obesity and difficult intubation: where is the evidence?. Anesthesiology, 104(3):617; author reply 618–619
  • 6. Lundstrøm LH, Møller AM, Rosenstock C, Astrup G, Wetterslev J. High body mass index is a weak predictor for difficult and failed tracheal intubation. Anesthesiology. 2009;110(2):266–74.
  • 7. Collins JS, Lemmens HJM, Brodsky JB, Brock-Utne JG, Levitan RM. Laryngoscopy and morbid obesity: a comparison of the ‘sniff’ and ‘ramped’ positions. Obes Surg. 2004;14(9):1171–75.
  • 8. Zvara DA, Calicott RW, Whelan DM. Positioning for intubation in morbidly obese patients. Anesth Analg. 2006;102(5):1592.
  • 9. De Jong A, Molinari N, Pouzeratte Y, et al. Difficult intubation in obese patients: incidence, risk factors, andcomplications in the operating theatre and in intensive care units. BJA. 2015; 114: 297-306.
  • 10. Gami AS, Caples SM, Somers VK. Obesity and obstructive sleep apnea. Endocrinol Metab Clin North Am. 2003;32(4):869–94.
  • 11. Valencia-Flores M, Orea A, Castaño VA, Resendiz M, Rosales M, Rebollar V, et al. Prevalence of sleep apnea and electrocardiographic disturbances in morbidly obese patients. Obes Res.2000;8(3):262–69.
  • 12. Tomi Pösö , Doris Kesek, Roman Aroch, Ola Winsö. Morbid obesity and optimization of preoperative fluid therapy. Obes Surg. 2013 Nov;23(11):1799-805. doi: 10.1007/s11695-013-0987-y.
  • 13. Messina A, Robba C, Calabrò L, Zambelli D, Iannuzzi F, Molinari E, Scarano S, Battaglini D, Baggiani M, De Mattei G, Saderi L, Sotgiu G, Pelosi P, Cecconi M. Perioperative liberal versus restrictive fluid strategies and postoperative outcomes: a systematic review and metanalysis on randomised-controlled trials in major abdominal elective surgery. Crit Care. 2021 Jun 11;25(1):205. doi: 10.1186/s13054-021-03629-y.
  • 14. Tolone S, Pilone V, Musella M, Rossetti G, Milone M, Fei L, Forestieri P, Docimo L. Rhabdomyolysis after bariatric surgery: a multicenter, prospective study on incidence, risk factors, and therapeutic strategy in a cohort from South Italy. Surg Obes Relat Dis. 2016 Feb;12(2):384-90. doi: 10.1016/j.soard.2015.11.005.
  • 15. Shen W, Wu Z, Wang Y, Sun Y, Wu A. Impact of Enhanced Recovery After Surgery (ERAS) protocol versus standard of care on postoperative Acute Kidney Injury (AKI): A meta-analysis. PLoS One. 2021 May 20;16(5):e0251476. doi: 10.1371/journal.pone.0251476.
  • 16. Romagnoli S, Zagli G, Tuccinardi G, Tofani L, Chelazzi C, et al. (2016) Postoperative acute kidney injury in high-risk patients undergoing major abdominal surgery. Journal of Critical Care 35: 120–125. https://doi.org/10.1016/j.jcrc.2016.05.012 PMID: 27481746
  • 17. O Connor ME, O Connor ME, Kirwan CJ, Kirwan CJ, Pearse RM, et al. (2016) Incidence and associations of acute kidney injury after major abdominal surgery. Intensive Care Medicine 42: 521–530. https://doi.org/10.1007/s00134-015-4157-7 PMID: 26602784
There are 17 citations in total.

Details

Primary Language Turkish
Subjects Anaesthesiology
Journal Section Research Articles
Authors

Sevim Cesur 0000-0002-8764-1251

Tülay Çardaközü 0000-0002-4936-8020

Nur Nazire Yucal 0000-0001-6449-3279

Sertaç Ata Güler 0000-0003-1616-9436

Publication Date October 15, 2022
Submission Date August 31, 2022
Acceptance Date October 7, 2022
Published in Issue Year 2022

Cite

AMA Cesur S, Çardaközü T, Yucal NN, Güler SA. Obezite cerrahisinde anestezi yönetimi: retrospektif çalışma. Acta Med Nicomedia. October 2022;5(3):148-151. doi:10.53446/actamednicomedia.1168926

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