Perioperative Rhabdomyolysis in Obese Individuals Undergoing Bariatric Surgery: Current Status

Area of Science:

• Anesthesiology
• Nephrology
• Surgical Complications

Background:

• Rhabdomyolysis is a serious complication of bariatric surgery.
• Risk factors include tissue compression and prolonged immobility, particularly in the lower extremities, gluteal, and lumbar regions.
• Clinical signs include muscle pain, weakness, and dark urine, with elevated serum creatine kinase as the key biomarker.

Purpose of the Study:

• To highlight the challenges in diagnosing and managing rhabdomyolysis in bariatric surgery patients.
• To emphasize the importance of prevention and early intervention.
• To discuss current management strategies and limitations in preventing renal injury.

Main Methods:

• Review of existing literature on intraoperative rhabdomyolysis in bariatric surgery.
• Analysis of clinical presentation, diagnostic biomarkers, and risk factors.
• Discussion of perioperative management, including hydration and resuscitation protocols.

Main Results:

• Tissue compression and prolonged immobilization are primary risk factors for rhabdomyolysis.
• Elevated serum creatine kinase is the most reliable diagnostic marker.
• Intravenous fluid resuscitation with Lactated Ringer's or 0.9% saline is crucial for managing hydration.

Conclusions:

• Perioperative diagnosis requires high clinical suspicion in bariatric patients.
• Prevention is paramount in this vulnerable population.
• Early treatment initiation is vital, though preventing secondary renal injury remains challenging.