Anaesthesia for adults undergoing non-bariatric surgery

Area of Science:

• Anesthesiology
• Public Health
• Bariatric Medicine

Background:

• Obesity is a global epidemic impacting healthcare systems worldwide.
• Anesthesiologists face increasing challenges in managing morbidly and super-obese patients.
• Effective perioperative care for obese patients necessitates specialized approaches.

Purpose of the Study:

• To outline essential considerations for optimal perioperative care in obese patients.
• To highlight the importance of environmental, evaluative, and equipment adaptations.
• To discuss pharmacokinetic and pathophysiological aspects relevant to obese patients.

Main Methods:

• Review of current literature and clinical guidelines for anesthetic management of obese patients.
• Focus on preoperative evaluation, including co-morbidities like diabetes, coronary artery disease, and obstructive sleep apnea.
• Emphasis on intraoperative management strategies, including positioning, monitoring, and ventilation.

Main Results:

• Optimal perioperative care requires adapted environments and equipment.
• Preoperative evaluation must thoroughly assess co-morbidities.
• Key intraoperative issues include preoxygenation, positioning, monitoring, and ventilation.

Conclusions:

• While co-morbidities are common in obese patients, overall morbidity and mortality are not significantly increased up to a BMI of 40 kg/m^2.
• Anesthesiologists must understand obesity's pharmacokinetic and pathophysiological effects.
• Successful perioperative care hinges on careful planning and adapted anesthetic techniques.