How can I manage anaesthesia in obese patients?

Publication date: Available online 14 February 2020Source: Anaesthesia Critical Care &Pain MedicineAuthor(s): Audrey De Jong, Amélie Rollé, François-Régis Souche, Olfa Yengui, Daniel Verzilli, Gérald Chanques, David Nocca, Emmanuel Futier, Samir JaberAbstractThe obese patient is at risk of perioperative complications including difficult airway access (intubation, difficult or impossible ventilation), and postextubation acute respiratory failure due to the formation of atelectases or to airway obstruction. The association of obstructive sleep apnoea syndrome (OSA) with obesity is very common, and induces a high risk of per and postoperative complications. Preoperative OSA screening is crucial in the obese patient, as well as its specific management: use of continuous positive pre-, per- and postoperative pressure. For any obese patient, the implementation of difficult intubation protocols and the use of protective ventilation (low tidal volume 6-8 ml/Kg of ideal body weight, moderate positive end-expiratory pressure of 10 cmH20, recruitment manoeuvres in absence of contra-indications), with morphine sparing and semi-seated positioning as much as possible is recommended, associated with a close postoperative monitoring. The dosage of anaesthetic drugs is usually based on the ideal body weight or the adjusted body weight and then titrated, except for succinylcholine that is dosed according to the total body weight. Monitoring of neuromuscul...
Source: Anaesthesia, Critical Care and Pain Medicine - Category: Anesthesiology Source Type: research

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Conditions:   Obstructive Sleep Apnea;   Alzheimer Disease;   Vascular Dementia;   Mild Cognitive Impairment;   Parkinsons Disease With Dementia;   Dementia With Lewy Bodies;   Mixed Dementia Interventions:   Device: In-laboratory polysomnography;   Device: Home Sleep Apnea Test Sponsors:   Sunnybrook Health Sciences Centre;   St. Michael's Hospital, Toronto Recruiting
Source: - Category: Research Source Type: clinical trials
Conditions:   Regional Anesthesia;   Computed Tomography;   Anatomical Description Intervention:   Sponsor:   Centre Hospitalier Universitaire de Besancon Not yet recruiting
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