致病性肥胖患者的麻醉.
Katharina Hardt1, Frank Wappler
1University Hospital of the Witten/Herdecke University - Cologne, Department of Anesthesiology and Operative Intensive Care Medicine, Cologne-Merheim Hospital.
Deutsches Arzteblatt international
|October 24, 2023
概括
麻醉科医生面临的挑战是照顾患有严重肥胖症的患者进行减肥手术. 精心的术前评估,麻醉选择和术后管理对于最佳的患者结果至关重要.
科学领域:
- 麻醉学 麻醉学
- 腹部外科 腹部外科
- 肥胖医学 肥胖医学
背景情况:
- 致病性肥胖 (BMI>35 kg/m2) 的流行率上升,增加了需要减肥手术的患者数量.
- 麻醉科医生越来越多地管理病态肥胖患者,特别是在专门的中心.
研究的目的:
- 对接受手术的致病肥胖患者进行麻醉学的考虑进行审查.
- 突出这一患者群体的术后护理的重要方面.
主要方法:
- 有关出版物的选择性PubMed搜索.
- 包括当前的指导方针,专家协会的建议和专家意见.
主要成果:
- 术前评估,风险分层以及仔细选择麻醉技术,药物和剂量至关重要.
- 了解病理生理学变化和并发症是必不可少的,因为肺部并发症 (呼吸衰竭,缺氧,呼吸暂停) 的风险更高,特别是阻塞性睡眠暂停.
- 建议使用短效,较少脂性麻醉药物,多式疼痛疗法和区域麻醉技术. 术后监测的指示取决于患者的因素和手术类型.
结论:
- 致病性肥胖患者的外科护理带来了独特的挑战.
- 麻醉科医生必须识别并发症,特定风险和病理生理变化,以有效管理患者.
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