Regional Anesthesia and Analgesia Techniques in Obese Patients

Study Overview
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Brief Summary
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Obesity is a health problem throughout the world and has increasingly become a widespread epidemic all over the world and also in Turkey. Anesthesia management of obese patients is challenging because of difficult airway, increased drug doses, co-morbidities, loss of anatomical landmarks and difficulties in positioning. Neuroaxial and peripheral nerve blocks are widely used in anesthesia practice in both obese and non-obese patients undergoing different surgical operations. In this prospective observational study, the investigators plan to enroll all patients that are applied neuroaxial or peripheral blocks during the study period. The aim of this study is to compare the differences and difficulties of regional anesthesia/analgesia techniques in obese and non-obese patients.

Detailed Description
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Obesity is a health problem throughout the world and has increasingly become a widespread epidemic all over the world and also in Turkey. Anesthesia management of obese patients is challenging because of difficult airway, increased drug doses, co-morbidities, loss of anatomical landmarks and difficulties in positioning. On the other hand, neuroaxial and peripheral nerve blocks are widely used in anesthesia practice in both obese and non-obese patients undergoing different surgical operations. In this prospective observational study, the investigators plan to enroll all patients that are applied neuroaxial or peripheral blocks during the study period. The difficulty of block performance, its relationship with experience, the requirement of changing hands with more experienced clinician, the requirement of changing patient position, regional anesthesia approach or needle (size and length), the requirement of adding rescue block, block success, performance duration, the number of needle direction (multiple attempts), the requirement of changing anesthesia or analgesia technique (conversion to general anesthesia), the requirement of adding another block monitorisation technique, adverse effect/complication, patient satisfaction and patient's request for a similar technique next time are all recorded both in obese and non-obese patients.

Official Title
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Use of Regional Anesthesia and Analgesia Techniques in Obese Patients: A Prospective Observational Study

Conditions
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Obesity, Regional Anesthesia

Intervention / Treatment
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* Other: Regional anesthesia/analgesia techniques


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients eligible for regional anesthesia/analgesia > 18 years old ASA 1-3 Exclusion Criteria: < 18 years old Patient refusal for regional anesthesia/analgesia Patient refusal to participate in the study Allergic to local anesthetics Psychiatric diseases Incapable to communicate

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Obese patients<br>Body mass index > 30 kg/m2 | Other: Regional anesthesia/analgesia techniques<br>* Neuroaxial or peripheral block anesthesia/analgesia technique that is appropriate for the patient's surgery<br>|
| Non-obese patients<br>Body mass index < 30 kg/m2 | Other: Regional anesthesia/analgesia techniques<br>* Neuroaxial or peripheral block anesthesia/analgesia technique that is appropriate for the patient's surgery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The difficulty of block performance | 0: easy, 1: difficult, 2: very difficult | through the block performance, within 5-10 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The experience of the anesthesiologist | 0: Junior resident, 1: senior resident, 2: attending anesthesiologist, 3: assoc.prof./prof.anesthesiologist | through the Anesthesiology residency training period, within 5 years and Anesthesiology experience, within 20 years | 
| The requirement of changing hands with a more experienced anesthesiologist | The number of changing | through the block performance, within 5-10 minutes | 
| The requirement of changing patient position | Yes/No | through the block performance, within 5-10 minutes | 
| The requirement of changing regional anesthesia/analgesia approach | Yes/No | through the block performance, within 5-10 minutes | 
| The requirement of changing needle size or length | Yes/No | through the block performance, within 5-10 minutes | 
| The requirement of adding rescue block | Yes/No | through the block performance, within 5-10 minutes | 
| Block performance duration | Time period | 0-30 minutes | 
| The number of needle direction | Number | through the block performance, within 5-10 minutes | 
| The requirement of conversion to general anesthesia | Yes/No | through the block performance, within 5-10 minutes | 
| The requirement of adding another block monitorization technique | Yes/No | through the block performance, within 5-10 minutes | 
| Adverse effect/complication rate | Yes/No | 1 week | 
| Block success | Yes/No | 0-30 minutes | 
| Patient satisfaction | 0-3 (0: not satisfied...3: very satisfied) | 1 week | 
| Patient's request for a similar technique next time | Yes/No | 1 week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Obesity, Neuroaxial blocks, Peripheral nerve blocks, Performance, Complication