Anesthesia and the Obese Patient

Patients undergoing surgery have little worry about the success of the procedure. The main priority is the effectiveness of the surgery itself. But what is equally important to the patient is the guarantee of anesthesia. The exact method of applying the anesthetic depends on the physiological condition of each patient. The use of clinical anesthesia for obese people is particularly complicated and poses a risk to the patient. As complications of anesthesia to obese people continue, forced treatment such as additional anesthesiologist training should be performed in all perioperative periods in order to reduce the risk of this growing patient population is there.

Currently, many obese patients are studying various bariatric surgeries and more and more CV disease experts are required to evaluate and eliminate anesthesia and surgery from these patients. Thirty-day mortality after gastric bypass surgery has been reported to be higher than recently expected, but it is closely related to the lack of surgeon experience (80). We also anticipate a long-term decline in all-cause mortality, particularly in cancer, DM and CV diseases, and CV risk in obese patients (81-85). Obesity surgery may reduce arterial pressure for a short period (2-3 years), but long-term (eg, 6-8 years) decline in HTN may not be observed (82, 86)

In many cases, change the anesthesia in patients (pediatric anesthesia, elderly people, obesity or obstetric anesthesia etc.) or special circumstances (special circumstances) for surgery (cardiac surgery, cardiothoracic anesthesia or neurosurgical surgery) Required injuries, pre-hospital care, robotic surgery, extreme environments, etc.

When general anesthesia is induced, patients can not protect their air passages or make effective breathing efforts. The purpose of care is to provide adequate ventilation and oxygen supply during general anesthesia. Patients were evaluated for mask ventilation and / or intubation difficulty during the preoperative period. Positioning is particularly important in morbidly obese patients. The physical habits of these patients make ventilation and intubation difficult. Ideal shading and intubation positions are referred to as "sniffer" positions. This is obtained by lifting the patient's jaw (in a supine position) so that the patient sucks air from the sectional view. Furthermore, raising the mandible downward (removing the tongue from the oropharynx) enables the simplest mask ventilation.