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Chapter 96 - Obesity

from Section 14 - Other Situations

Published online by Cambridge University Press:  03 August 2023

By
Serle Levin ,
Jeffrey A. Brown  and
Jessica A. Lovich-Sapola
Edited by
Jessica A. Lovich-Sapola
Jessica A. Lovich-Sapola
Affiliation:
Cleveland Clinic, Ohio
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Summary

A 48-year-old, 223 kg female is scheduled for a gastric bypass surgery. Her medical history is significant for osteoarthritis, hypertension, type II diabetes mellitus, and gastroesophageal reflux disease. She uses a continuous positive airway pressure (CPAP) machine at home. What are your concerns? How would you approach this patient? Are there any tests you would like to have before surgery? How would you induce anesthesia in this patient? What would you use for maintenance of anesthesia?

Type
Chapter
Information
Anesthesia Oral Board Review
Knocking Out The Boards
 , pp. 409 - 412
Publisher: Cambridge University Press
Print publication year: 2023

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References

Barash, PG, Cullen, BF, Stoelting, RK, et al. Clinical Anesthesia, 8th ed. Philadelphia: Lippincott Williams & Wilkins, 2017, pp. 1277–93.Google Scholar
Butterworth, JF, Mackey, DC, Wasnick, JD. Morgan & Mikhail’s Clinical Anesthesiology, 6th ed. New York: McGraw-Hill Education, 2018, pp. 767–9.Google Scholar
Chung, F, Yegneswaran, B, Liao, P, et al. STOP Questionnaire: a tool to screen for obstructive sleep apnea. Anesthesiology 2008;108:812–21.Google ScholarPubMed
Gounden, R, Blackman, M. Clinical pharmacology: dosing in the obese patient. Clin Pharmacol 2006;24(7):399–400.Google Scholar
Groper, MA. Miller’s Anesthesia, 9th ed. Philadelphia: Elsevier, 2020, pp. 1911–28.Google Scholar
Stenberg, E, Dos Reis Falcão, LF, O’Kane, M, et al. Guidelines for perioperative care in bariatric surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: a 2021 update. World J Surg 2022. doi:10.1007/s00268-021-06394-9.CrossRefGoogle Scholar
Vikram, M, Hashmi, J, Singh, R, et al. Comparative evaluation of gastric pH and volume in morbidly obese and lean patients undergoing elective surgery and effects of aspiration prophylaxis. J Clin Anesth 2015; 27(5):396–400.Google Scholar

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