Controversies in the Anesthetic Management of the Obese Surgical Patient

1. Front Matter

   Pages i-xiv

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2. Introduction

   1. Front Matter

      Pages 1-1

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3. Introduction

   1. Should Anesthesiologists Managing Morbidly Obese Patients Receive Special Education and Training?

      • Anupama Wadhwa, Adrian O. Alvarez

      Pages 3-13

   2. How Should Obesity be Measured and How Should Anesthetic Drug Dosage be Calculated?

      • Luc E. C. De Baerdemaeker, Jurgen G. M. Van Limmen, Yves Van Nieuwenhove

      Pages 15-30

4. Preoperative Concerns

   1. Front Matter

      Pages 31-31

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   2. What are the Important Perioperative Risk Factors for Morbidly Obese Patients?

      • Roman Schumann

      Pages 33-40

   3. Does Every Morbidly Obese Patient Need a Complete Preoperative Workup?

      • Samuel R. Grodofsky, Ashish C. Sinha

      Pages 41-51

   4. Obesity and Metabolic Syndrome: Considerations from Anesthesiologists

      • Antonino Gullo, Chiara Maria Celestre, Annalaura Paratore

      Pages 53-67

   5. Is a Full Cardiac Workup Indicated for Morbidly Obese Patients with Cardiac Disease?

      • Donald P. Bernstein

      Pages 69-80

   6. How and When Should Diabetes in the Obese Patient be Treated?

      • Luca Busetto

      Pages 81-90

   7. How Should You Manage Anti-Hypertensive Drugs in Morbidly Obese Surgical Patients?

      • Donald P. Bernstein

      Pages 91-101

   8. Should all Morbidly Obese Patients be Evaluated for Obstructive Sleep Apnea?

      • Waleed Riad, Frances Chung

      Pages 103-110

   9. Are MO Patients at Increased Risk for Gastric Acid Aspiration?

      • Bruno Dillemans, Sebastiaan Van Cauwenberge, Hanne Vanommeslaeghe

      Pages 111-120

   10. What is the Role for Preoperative Physical Training and Respiratory Kinesitherapy in Obese Surgical Patients?

       • Luc E. C. De Baerdemaeker, Steven Rimbaut

       Pages 121-128

5. Intraoperative Management

   1. Front Matter

      Pages 129-129

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   2. Which Intraoperative Monitors are Essential for the Obese Surgical Patient?

      • Linda Miotto, Tommaso Pellis

      Pages 131-139

   3. What is the Optimal Position for Induction of Anesthesia for a Morbidly Obese Patient?

      • Jay B. Brodsky

      Pages 141-144

   4. Do All Morbidly Obese Patients Have a “Difficult” Airway?

      • Jeremy S. Collins

      Pages 145-156

   5. What is the Best Way to Induce General Anesthesia in Obese Patients?

      • Luis A. Verduzco, Harry J. Lemmens

      Pages 157-168

   6. Do Supraglottic Airways Have a Role in the Anesthetic Management of Obese Patients?

      • Grégory A. Hans, Jean L. Joris

      Pages 169-177

The prevalence of obesity, an important risk factor for various diseases, has increased markedly worldwide in recent years. The results of long-term dietary behavioural therapy, however, remain sadly inadequate, with a relapse rate of about 90%. Surgery is still the only effective treatment for these patients. The annual number of weight loss operations performed in the United States in the early 1990s totaled only about 16,000, but by 2005 the figure exceeded 200,000. The anesthetic care of severely obese patients entails particular issues, and difficulties are believed to escalate in the presence of co-morbidities. Despite this, outcome data in respect of anesthetic care and pain management are still scarce. Anesthetic Management of the Obese Patient considers a wide range of important practical issues and controversies. Key questions in preoperative, intraoperative, and postoperative management are carefully addressed, and different approaches are evaluated, casting light on their effectiveness and limitations. Written by world leaders in the field, this book will be an invaluable aid for anesthesiologists.

• Anesthesiology
• Bariatric Surgery
• Controversies in Management
• Morbid Obesity
• Pharmacology

From the book reviews:

“This book addresses an interesting topic area, and one which has gained increasing focus both in the professional and lay press over recent years. … it is an excellent resource for somebody new to the field or who is an ‘occasional’ bariatric anaesthetist. I would recommend it to trainees preparing for the fellowship, but also as CPD for consultants and career grades who are engaged in ‘occasional’ bariatric practice.” (M. Bellamy, British Journal of Anaesthesia, Vol. 113 (6), December, 2014)

“Each chapter, written by a different set of experts, is presented as a controversy in the management of the morbidly obese. … those who wish to read a review of expert opinions and current literature in the field of morbid obesity will find the text useful. … the editors have produced a book that consolidates the current literature and expert opinion pertaining to the perioperative management of the morbidly obese.” (Albert Moore, Canadian Journal of Anesthesia/Journal canadien d'anesthésie, Vol. 60, 2013)

• Santa Maria degli Angeli Medical Centre, Pordenone, Italy

  Yigal Leykin

• Stanford University School of Medicine, Stanford, USA

  Jay B. Brodsky

Policies and ethics