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per Medici e Operatori Sanitari
per Medici e Operatori Sanitari
LIBRERIA STUDIUM
Controversies in the Anesthetic Management of the Obese Surgical Patient
Leykin, Brodsky
Editore
Springer
Anno
2013
Pagine
303
ISBN
9788847026346
90,00 €
- Considers practical issues and controversies in the obese anesthetic management
- Simple to consult
- Addresses key questions in pre-, intra- and postoperative phase
The worldwide prevalence of obesity has increased dramatically in recent years. Since the results of long-term dietary behavioral therapy remain sadly inadequate, surgery is currently the only effective treatment for patients with severe or morbid obesity. The numbers of weight loss operations continue to increase annually throughout the world. The anesthetic management of severely obese patients entails special challenges, especially when medical co-morbidities are present. Published outcome data on anesthetic care and pain management of these patients are scarce, and many practices remain controversial. Controversies in the Anesthetic Management of Obese Patients considers a wide range of important practical issues. Key questions in preoperative, intraoperative, and postoperative management are addressed, and different approaches are evaluated. Written by international leaders in the field, this book will be an invaluable aid for anesthesia care providers.
Contents
Part I Introduction
1 Should Anesthesiologists Managing Morbidly Obese Patients
Receive Special Education and Training? . . . . . . . . . . . . . . . . . . 3
Anupama Wadhwa and Adrian O. Alvarez
2 How Should Obesity be Measured and How Should Anesthetic
Drug Dosage be Calculated? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Luc E. C. De Baerdemaeker, Jurgen G. M. Van Limmen
and Yves Van Nieuwenhove
Part II Preoperative Concerns
3 What are the Important Perioperative Risk Factors for Morbidly
Obese Patients? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33
Roman Schumann
4 Does Every Morbidly Obese Patient Need a Complete
Preoperative Workup? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41
Samuel R. Grodofsky and Ashish C. Sinha
5 Obesity and Metabolic Syndrome: Considerations
from Anesthesiologists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Antonino Gullo, Chiara Maria Celestre and Annalaura Paratore
6 Is a Full Cardiac Workup Indicated for Morbidly Obese
Patients with Cardiac Disease? . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Donald P. Bernstein
vii
7 How and When Should Diabetes in the Obese
Patient be Treated? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Luca Busetto
8 How Should You Manage Anti-Hypertensive Drugs
in Morbidly Obese Surgical Patients? . . . . . . . . . . . . . . . . . . . . . 91
Donald P. Bernstein
9 Should all Morbidly Obese Patients be Evaluated
for Obstructive Sleep Apnea? . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
Waleed Riad and Frances Chung
10 Are MO Patients at Increased Risk for Gastric
Acid Aspiration? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Bruno Dillemans, Sebastiaan Van Cauwenberge
and Hanne Vanommeslaeghe
11 What is the Role for Preoperative Physical Training
and Respiratory Kinesitherapy in Obese Surgical Patients? . . . . . 121
Luc E. C. De Baerdemaeker and Steven Rimbaut
Part III Intraoperative Management
12 Which Intraoperative Monitors are Essential
for the Obese Surgical Patient?. . . . . . . . . . . . . . . . . . . . . . . . . . 131
Linda Miotto and Tommaso Pellis
13 What is the Optimal Position for Induction of Anesthesia
for a Morbidly Obese Patient? . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Jay B. Brodsky
14 Do All Morbidly Obese Patients Have a ‘‘Difficult’’ Airway? . . . . 145
Jeremy S. Collins
15 What is the Best Way to Induce General Anesthesia
in Obese Patients? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
Luis A. Verduzco and Harry J. Lemmens
16 Do Supraglottic Airways Have a Role in the Anesthetic
Management of Obese Patients? . . . . . . . . . . . . . . . . . . . . . . . . . 169
Grégory A. Hans and Jean L. Joris
viii Contents
17 Is Protective Lung Ventilation Safe in Morbidly
Obese Patients? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Paolo Pelosi, Claudia Brusasco and Henrik Reinius
18 Does Choice of Inhaled Anesthetic Agent Matter? . . . . . . . . . . . . 199
Francesco Giunta, Claudio Di Salvo, Antonio Rubino
and Elena Marini
19 What is Optimal Fluid Management of the Obese
Surgical Patient? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
Jerry Ingrande
20 What are the Challenges of Laparoscopy
in Morbid Obese Patients? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219
Jan P. Mulier and Philippe Van Lancker
21 Is There a Role for Regional Anesthesia in the Obese Patient?. . . 227
T. Edward Kim and Edward R. Mariano
Part IV Postoperative Concerns
22 Should Obese Surgical Patients be Recovered
in an ICU or PACU? Should all Postoperative MO Patients
be Monitored During Their Entire Hospitalization?. . . . . . . . . . . 241
Heather Murray, Andrew Kendall and Mike Margarson
23 Is Postoperative Opioid Analgesia Safe for Obese Patients? . . . . . 255
Fernanda Tagliaferri, Marco Berti, Raffaella Troglio
and Guido Fanelli
24 What is the Role of Analgesic Adjuncts in Obese Patients? . . . . . 261
Daniel M. Pöpping, Manuel Wenk and Stephan A. Schug
Part V Other Controversies
25 Can Morbidly Obese Patients Safely Undergo Surgery
at an Outpatient Surgery Center?. . . . . . . . . . . . . . . . . . . . . . . . 271
Jay B. Brodsky
26 What Physiological Changes Occur After Bariatric Surgery
and are They Important to the Anesthesiologist? . . . . . . . . . . . . . 277
Marco Berti, Raffaella Troglio and Fernanda Tagliaferri
Contents ix
27 Which Anesthetic (General or Regional) is Safest for a
Caesarean Section in a Morbidly Obese Parturient? . . . . . . . . . . 291
Yigal Leykin, Linda Miotto and Gianfederico Zannier
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
x Contents
