Anesthesia in 200 kg weight patient during laparascopic hysterectomy (clinical case)
M. A Anisimov , E. S Gorobets
Regional Anesthesia and Acute Pain Management ›› 2014, Vol. 8 ›› Issue (3) : 51 -56.
Anesthesia in 200 kg weight patient during laparascopic hysterectomy (clinical case)
45 years old 200 kg weight female (BMI 73 kg/m 2) had been operated on for uterus cancer under combined anesthesia (desflurane general anesthesia with epidural analgesia: naropin 2 mg/ml+fentanyl 2 mcg/ml+adrenaline 2 mcg/ml). The case was used as the example, described the clinical approach to such complicated cohort of patients with the accents on patient position, intubation, respiratory and hemodynamic problems. The epidural analgesia is regarded one of the perioperative corner stones in anesthetic approach to morbidly obese patients.
morbid obesity / anesthesia / desflurane / epidural analgesia / laparoscopic hysterectomy
| [1] |
Adrian Alvarez, Jay B. Brodsky Hendrikus J.M. Lemmen, John M. Morton Morbid Obesity Peri-operative Management 2nd ed. New York: Cambridge University Press; 2010. |
| [2] |
Vilma E. Ortiz, Jeanine Wiener-Kronish. Perioperative anesthetic care of the obese patient, New York: Informa Healthcare USA; 2010. |
| [3] |
Bray G.A., Pathophysiology of obesity Am J Clin Nutr. 1992; 55:488S-494S. |
| [4] |
Mulier J.P., Garcia M. and Dillemans B. Pathophysiology of obesity. Impact on laparoscopy Acta Anaesth. Belg. 2009; 60: 149-153. |
| [5] |
Tung A. Anaesthetic considerations with the metabolic syndrome British Journal of Anaesthesia. 2010; 105 (S1): i24 - i33. |
| [6] |
De Baerdemaeker, L.E., C. Van der Herten, et al. Comparison of volumecontrolled and pressure-controlled ventilation during laparoscopic gastric banding in morbidly obese patients. Obes Surg. 2008; 18 (6): 680-685. |
| [7] |
Michael S. Kristensen Airway management and morbid obesity Eur J Anaesthesiol. 2010; 27: 923-927. |
| [8] |
Aldenkortt M., Lysakowski C., Elia N. et al. Ventilation strategies in obese patients undergoing surgery: a quantitative systematic review and meta-analysis British Journal of Anaesthesia. 2012; 109 (4): 493-502. |
| [9] |
Meyhoff C.S., Lund J., Jenstrup M.T., Claudius C., Sorensen A.M., Viby-Mogensen J., Rasmussen L.S. Should dosing of rocuronium in obese patients be based on ideal or corrected body weight? Anesth. Analg. 2009; 109:787-792. |
| [10] |
Van Lancker P., Dillemans B., Bogaert T., Mulier J.P., De Kock M., Haspeslagh M. ideal versus corrected body weight fior dosage of sugammadex in morbidly obese patients. Anaesthesia. 2011; 66: 721-725. |
| [11] |
Breivik H., Borchgrevink P.C., Allen S.M., et al. Assessment of pain. British Journal of Anaesthesia. 2008; 101 (1): 17-24. |
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