A patient undergoing surgery has only a few concerns regarding a successful operation. The main priority is the efficacy of the operation itself. Equally critical to a patient, however, is the assurance of anesthesia. Precise methods of anesthesia application vary according to each patient’s physiological conditions. Clinical anesthesia use on the obese is particularly complex, posing dangers to the patients. As complications continue to arise from the use of anesthesia on the obese, mandatory measures such as additional anesthetist training should be implemented on all perioperative stages to reduce risks to this growing patient population. Obesity is now considered a global epidemic, with particularly concentrated numbers in the United States. In 2011-2012 more than one-third of U.S. adults were estimated to be obese (National Center for Health Statistics, 2013). Due to the increasing prevalence of the epidemic, anesthesiologists must manage a significant number of clinically obese patients. A large range of physiological variations are associated with obesity, including cardiac, respiratory, and metabolic functions (Leykin, v). The areas of concern for anesthesiologists when operating on the obese can be separated into three perioperative stages: preoperative, intraoperative, and postoperative. Preoperative concerns are primarily focused around the specific medical conditions of each patient. As anesthesia is intricately tailored to patient specific requirements, it is of central importance that all factors are taken into consideration before surgery. This is especially true for the obese, who are likely to suffer from comorbidities (having more than one disease). Metabolic syndrome, a collective set of ... ... middle of paper ... ...1 (2012): 81-88. Web. Myatt, John, and Kevin Haire. "Airway Management in Obese Patients." Current Anaesthesia & Critical Care 21.1 (2010): 9-15. Web. Neligan, Patrick J. "Metabolic Syndrome: Anesthesia for Morbid Obesity." Current Opinion in Anaesthesiology 23.3 (2010): 375-83. Web. Novation. Bariatric Supplies Market Research Report. Rep. N.p., Nov. 2012. Web. Porhomayon, J., P. Papadakos, and ND Nader. "Alteration in Respiratory Physiology in Obesity for Anesthesia-critical Care Physician." HSR Proceedings in Intensive Care and Cardiovascular Anesthesia 3.2 (2011): 109-18. Web. "Prevalence of Obesity Among Adults: United States, 2011–2012." National Center for Health Statistics. N.p., n.d. Web. . Stone, Julian, and William Fawcett. Anaesthesia at a Glance. N.p.: Wiley, 2013. Print.
Smith, C., Sidhu, R., Lucas, L., Mehta, D., & Pinchak, A. (2007, March 13). Should patients undergoing ambulatory surgery with general anesthesia be actively warmed? Internet Journal of Anesthesiology, 12(1).
Bariatrics is the branch of medicine that focuses on the causes, prevention, and treatment of obesity. Bariatric surgery is a specific discourse community connecting individuals through mutual interests, shared knowledge, and expertise of treating obese populations. The field of bariatrics is a discourse community with several purposes. It encourages innovative surgical and nonsurgical solutions in obesity care. It formulates hypotheses and develops and conducts experimental designs to test the hypotheses’ reliability and validity. Furthermore, it aims to stimulate discussion about its findings.
The term “bariatric” surgery, derived from the Greek word baros for weight, defines surgical procedures designed to produce substantial weight loss. Accordingly, goals of bariatric surgery originally evolved around achieving substantial sustained weight loss. In reality, weight loss is only one of the outcomes of such surgery. Bariatric surgery can be associated with substantial other health benefits including improvement or normalisation of hyperglycaemia. hyperlipidaemia, blood pressure, obstructive sleep apnoea and improved quality of life41. (2)
Berstein RS; Thornton JC; Yang MU; Wang J; Redmond AM; Pierson RN Jr; Pi-Sunyer FX; Van Itallie TB. (1983a). Prediction of the Resting Metabolic Rate in obese patients. American Journal of Clinical Nutrition, 1983 Apr, 37(4): 595-602.
"Prevalence of Childhood and Adult Obesity in the United States, 2011-2012." JAMA Network. N.p., n.d. Web. 5 Apr. 2014.
Jin, Jill. "Obesity and the Heart." JAMA 310.19 (2013): 2113. JAMA Network. Web. 16 Mar. 2014.
Individuals need to understand the use of anesthesia always comes with risks. In most cases, however, it's safe when administered by someone with the proper training. Certain individuals, such as those with obstructive sleep apnea or ones who are obese, need to speak to their physician before being sedated, as their risk of complications is higher.
Obese patients had significantly greater reduction in BMI and weight but less improvement in exercise capacity th...
American Association of Nurse Anesthetists. Professional Aspects of Nurse Anesthesia Practice. Philadelphia: F. A. Davis Company, 1994. Print.
Bariatric surgery or the weight-loss surgery is an operation performed on abnormally obese people with a body mass index greater than 40 and is a service provided by an inter-disciplinary team – psychiatric, endocrine, rehab, nutritionist, cardiologist, and pulmonologist. Studies have shown that in seriously obese people, having weight loss surgery means they are likely to live longer because of the less risk of stroke, heart attacks, some types of cancer, and liver diseases. By dividin...
Jayasekara, Rasika. "Weight Loss Surgery for Obesity." AJN, American Journal of Nursing 110.1 (2010): 1-61. Cochrane Corner. Web. 20 Nov. 2013.
Maggard M, Shugarman L, Suttorp M, et al. Meta-Analysis: Surgical Treatment of Obesity. Ann Intern Med. 2005;142(7):547-559.
Obesity is considered a chronic and multifactorial disease that has been increasing every day, just like its physical and psychological clinical comorbities. The bariatric surgery emerges as a surgical procedure to treat this disease, and considering the complexity of contributing factors for the obesity, it is necessary to understand the importance of multidisciplinary monitoring of the surgical team and the role of the psychologist in this context. From a qualitative research with EXPLORATORY DESCRIPTIVE DESIGN, guided by ethical principles, this study had semi-structured interviews, recorded and transcribed, to understand the role of the psychologist in the process of monitoring bariatric patients, supported by the perception of four psychoanalysts
Siddique, M. I., Mahmud, I., & Siddique, R. M. (2010). Obesity and sleep disorders: Implications for bariatric patients. Bariatric Nursing And Surgical Patient Care, 5(1), 75-79. doi:10.1089/bar.2009.9937
Physical dimension can make difficult even the most basic nursing interventions for overweight patients. The areas which may create major nursing concerns are general assessment, skin care, resuscitation measures, respiratory challenges, intravenous access, altered drug absorption and immobility. As the pressure within the skin folds in overweight clients is high and it is sufficient to cause skin breakdown, atypical pressure ulcers are formed. In obese clients catheters, tubes and drainages can tunnel into the skin and soft tissues. Changing the position is another complicated concern for obese patients who are confined to bed. Use of a blood pressure cuff which is too small or attaching the cuff as one to attempt to make it fit w...