Our anesthetic experiences with morbidly, super and super super obese patients underwent laparoscopic gastric sleeve surgery
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Tarih
2015
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Anestezi Dergisi
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Objective: Obesity is clinically defined with BMI (body mass index) greater than 30 kg m-2 and BMI over the 40 kg m-2 is defined as "morbid obesity", over the 50 kg m-2 BMI is defined as "super obesity" and if BMI is more than 60 kg m-2 it is defined as "super super obesity". Anesthetic management is important because of the problems in cases undergoing bariatric surgery such as ventilation and intubation difficulties, anesthetic drug and dose selection, fluid management and securing airway in postoperative period. In this study, we aimed to share our experiences with morbid, super and super super obese patients underwent laparoscopic gastric sleeve (LGS) surgery. Method: The study performed by the retrospective analysis of 20 patients underwent LGS surgery. Fentanyl 1-2 ?g kg-1 ideal body weight (IBW), propofol 1.5-2.5 mg kg-1 total body weight and rocuronium 0.6-0.8 mg kg-1 IBW administered intravenously for anesthesia induction, patients' intubation was performed in the reverse trendelenburg and the ramp position. Desflurane and remifentanil infusion are used for maintenance. Recruitment maneuver and 3-4 mg kg-1 iv sugammadex used.before the extubation. Results: The women-to-men ratio was 18/2, BMI was 51.4 kg m-2, and 11 were morbid obese, 6 were super obese, 3 were super super obese of the patients. ASA II/III/IV scores were 1/13/6 respectively. STOP BANG questionnaire was given to thirteen patients and intubation was performed in the ramp position. Conclusion: We think making an optimal preoperative preparation, choosing short acting and low doses of intravenous anesthetics, putting patient in ramp position for intubation, applying peroperative PEEP, providing adequate analgesia and antagonising neuromuscular block with sugammadex would prevent the postoperative complications in cases undergoing LGS surgery.
Açıklama
Anahtar Kelimeler
Anesthesia; Laparoscopic sleeve gastrectomy; Morbid; Super super obese
Kaynak
Anestezi Dergisi
WoS Q Değeri
Scopus Q Değeri
Q4
Cilt
23
Sayı
2
