Controversies in the Anesthetic Management of the Obese Surgical Patient [electronic resource] /
Leykin, Yigal.editor.
Brodsky, Jay B.editor.
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.
Description based upon print version of record.
Controversiesin the Anesthetic Management of the Obese Surgical Patient; Preface; Contents; Contributors; Part I Introduction; 1 Should Anesthesiologists Managing Morbidly Obese Patients Receive Special EducationSpecial Education and TrainingTraining?; Abstract; 1.1...Introduction; 1.2...Alterations Associated with Morbid Obesity; 1.2.1 Anatomy; 1.2.2 Physiology; 1.2.3 Pharmacology; 1.3...What Does it Mean for an Anesthesiologist to be Ready for MO Patients?; 1.4...Current Format of Learning and EducationEducation; 1.5...Current TrainingTraining Strategies for Residents and Practitioners
1.6...Anesthesia Practitioners1.7...Our Proposal for Educational and TrainingTraining Strategies; 1.7.1 Potential Sources of Training; 1.7.1.1 Simulation-Based Training; 1.7.1.2 Clinical Training; 1.7.1.3 On-Line Resources; 1.7.1.4 Scientific Meetings; 1.7.1.5 Printed Sources; 1.8...Conclusions; References; 2 How Should Obesity be Measured and How Should Anesthetic Drug Dosage be Calculated?; Abstract; 2.1...Introduction; 2.2...The Problems with Assessing Excess Adiposity; 2.3...Methods for Assessing Adiposity; 2.3.1 Body Weight and BMI; 2.3.2 Assessing Body Fat Distribution; 2.3.2.1 Waist Circumference
2.3.2.2 Hip Circumference2.3.2.3 Other Body Circumferences; 2.3.2.4 Ratios; 2.3.2.5 Sagittal Abdominal Diameter; 2.3.2.6 CT and MRI; 2.4...Methods for Assessing Body CompositionBody Composition; 2.4.1 Anthropometry; 2.4.2 Dual-Energy X-ray Absorptiometry; 2.4.3 Bioelectric Impedance Analysis; 2.5...How Should These Measurements be Used to Calculate Anesthetic Drug Dosage?; 2.5.1 Total Body Weight; 2.5.2 Lean Body Weight; 2.5.3 Ideal Body Weight and Corrected Body Weight; 2.5.4 Pharmocokinetic Mass; 2.5.5 Allometric Scaling; 2.6...Practical Guidelines; 2.7...Conclusions; References
Part II Preoperative Concerns3 What are the Important Perioperative Risk Factors for Morbidly Obese Patients?; Abstract; 3.1...Introduction; 3.2...The Metabolic Syndrome; 3.3...Obstructive Sleep Apnea; 3.4...Cardiovascular Disease; 3.5...Pregnancy; 3.6...Conclusions; References; 4 Does Every Morbidly Obese Patient Need a Complete Preoperative Workup?; Abstract; 4.1...Introduction; 4.2...Cardiac; 4.3...Pulmonary; 4.4...Renal and Electrolytes; 4.5...Hepatic; 4.6...Hematologic; 4.7...Endocrine; 4.8...Preoperative Workup Specific to Bariatric Surgery; 4.9...Conclusions; References
5 Obesity and Metabolic Syndrome: Considerations from AnesthesiologistsAbstract; 5.1...Background; 5.2...Pathophysiology of Obesity; 5.3...Clinical Assessment in Adults, Children and Adolescents; 5.4...Obesity: At Risk Patients and Scoring System; 5.4.1 Physical Assessment; 5.4.2 Monitoring; 5.5...Metabolic Syndrome; 5.5.1 Therapeutic Implications; 5.5.1.1 Obesity and Body Fat Distribution as Targets of Therapy; 5.5.1.2 Insulin Resistance as Target of Therapy; 5.6...Obesity and Perioperative Medicine; 5.7...Obesity Related Health Cost; 5.7.1 Financial Burden of Obesity; 5.8...Conclusion; References
6 Is a Full Cardiac Workup Indicated for Morbidly Obese Patients with Cardiac Disease?
Includes bibliographical references and index.
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.
Emergency medicine.
Emergency Medicine.