Morbid Obesity: Peri-operative Management PDF
Preview Morbid Obesity: Peri-operative Management
This page intentionally left blank Morbid Obesity Peri-operative Management Second Edition Morbid Obesity Peri-operative Management Second Edition Editors Adrian Alvarez Staff Anesthesiologist, Hospital Italiano, Buenos Aires, Argentina Jay B. Brodsky Professor, Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA Hendrikus J. M. Lemmens Professor, Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA John M. Morton Associate Professor, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA CAMBRIDGE UNIVERSITY PRESS Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo, Delhi, Dubai, Tokyo Cambridge University Press The Edinburgh Building, Cambridge CB2 8RU, UK Published in the United States of America by Cambridge University Press, New York www.cambridge.org Information on this title: www.cambridge.org/9780521518840 © Cambridge University Press 2010 This publication is in copyright. Subject to statutory exception and to the provision of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published in print format 2010 ISBN-13 978-0-511-67721-2 eBook (NetLibrary) ISBN-13 978-0-521-51884-0 Hardback Cambridge University Press has no responsibility for the persistence or accuracy of urls for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Contents List of contributors vii Preface to second edition x Preface to first edition xi List of abbreviations xiii Section 1: Pathophysiology 11. Effects of obesity on anesthetic agents 100 Hendrikus J.M. Lemmens and Jerry Ingrande 1. Cardiovascular physiology 1 12. Airway management 111 Donald P. Bernstein Jeremy Collins 2. Pulmonary physiology and sleep disordered 13. Ventilatory strategies during anesthesia 124 breathing 1 9 Juraj Sprung, Toby N. Weingarten and Roman Schumann and Stephanie B. Jones David O. Warner 3. Digestive and metabolic physiology of 14. Regional anesthesia and obesity 138 obesity 2 8 Pedro P. Tanaka and Jay B. Brodsky Patrick J. Neligan 4. Pathophysiology of the Section 4: Post-operative conditions pneumoperitoneum 4 4 15. Post-operative analgesia 144 Brian R. Smith and Ninh T. Nguyen Adrian Alvarez, Silvia E. Perez-Pretto, Kathleen Section 2: Preparation and pre-operative Carey and Ashish Sinha evaluation/management 16. Post-anesthesia care unit: Management of anesthetic and surgical complications 155 5. Choice of bariatric operation 5 3 Stephanie B. Jones, Roman Schumann and Deborah Abeles, Brandon Tari and Scott A. Shikora Daniel B. Jones 6. Informed consent 6 3 17. Intensive care management of the Steve E. Raper critically ill obese patient 161 Jenny Choi and Alfons Pomp 7. Pre-operative surgical management 7 2 Basil M. Yurcisin and Eric J. DeMaria 18. Post-operative rhabdomyolysis 173 João Ettinger, Paulo Batista and Euler Ázaro 8. Pre-operative management: Nutritionist/ psychologist/internist 7 9 19. Nursing considerations 182 Helen Karakelides and Maria L. Collazo-Clavell Tracy Martinez Section 3: Intra-operative 20. Long-term complications following surgery 188 management Masha Livhits, Amy Lightner and Melinda A. Maggard 9. Positioning 8 5 Jay B. Brodsky 21. Anesthetic considerations for the post- bariatric surgery patient 198 10. Monitoring the morbidly obese patient 9 2 Joseph G. Werner, David Zvara, Ronald Harter Donald P. Bernstein and Galina Dimirova vv Contents 22. Bariatric outcomes 208 24. Bariatric surgery in adolescents 222 Gavitt A. Woodard and John M. Morton Venita Chandra and Sanjeev Dutta Section 5: Special topics 25. Management of the obese parturient 233 Yigal Leykin 23. Organizing a bariatric team 216 Fawzi S. Khayat and Matthew M. Hutter Index 240 vi Contributors Deborah Abeles Jenny Choi Obesity Treatment Centers of New Jersey Fellow, Section of Laparoscopic and Bariatric Morristown Memorial Hospital, NJ, USA Surgery, Weill Cornell Medical College, NY, USA Adrian Alvarez Maria L. Collazo-Clavell Staff Anesthesiologist, Hospital Italiano, Consultant, Division of Endocrinology, Diabetes, Buenos Aires, Argentina Metabolism and Nutrition Associate Professor of Medicine, Mayo Clinic Euler Ázaro College of Medicine, MN, USA Associate Professor of Surgery Jeremy Collins Department of Surgery, Escola Bahiana de Medicina e Saúde Pública, Salvador, Clinical Assistant Professor, Anesthesia Bahia, Brazil Stanford University Medical Center, CA, USA Bariatric Surgery Unit , Hospital São Rafael and Eric J. DeMaria Hospital Cidade, Salvador, Bahia, Brazil Vice Chair, Network General Surgery, Duke Paulo Batista University Medical Center, NC, USA Associate Professor of Internal Medicine , Escola Galina Dimirova Bahiana de Medicina e Saúde Pública, Associate Professor Clinical, The Ohio State Salvador, Bahia, Brazil University Medical Center, OH, USA Department of Internal Medicine and Bariatric Sanjeev Dutta Surgery Unit, Hospital São Rafael and Hospital Cidade, Salvador, Bahia, Brazil Assistant Professor of Surgery and Pediatrics Lucille Packard Children’s Hospital Donald P. Bernstein Stanford University School of Medicine, CA, USA Attending Anesthesiologist , Palomar Medical João Ettinger Center and the Palomar-Pomerado Research Institute, CA, USA Associate Professor of Surgery, Escola Bahiana de Medicina e Saúde Pública Jay B. Brodsky Bariatric and Metabolic Surgery Fellowship Professor of Anesthesia , Medical Director – Peri- Bariatric Surgery Unit, Hospital São Rafael and operative Services, Stanford University Medical Hospital Cidade, Salvador, Bahia, Brazil Center, CA, USA Ronald Harter Kathleen Carey Associate Professor of Surgery The Ohio State Medical Student, University of Pennsylvania University Medical Center, OH, USA School of Medicine, PA, USA Matthew M. Hutter Venita Chandra Assistant Professor, Director of the Codman Surgical Resident, Stanford University Medical Center for Clinical Effectiveness in Surgery, Center, CA, USA Massachusetts General Hospital, MA, USA vviiii List of contributors Jerry Ingrande Surgical Quality and Bariatric Surgery, Stanford Research Fellow, Stanford University School of University School of Medicine, CA, USA Medicine, CA, USA Patrick J. Neligan Daniel B. Jones Honorary Senior Lecturer in Anaesthesia, Rabkin Fellow in Medical Education Associate National University of Ireland, Galway, Ireland Professor of Surgery, Beth Israel Deaconess Consultant in Anaesthesia and Intensive Care Medical Center, Harvard Medical School, MA, Medicine, University College Hospitals, USA Galway, Ireland Stephanie B. Jones Ninh T. Nguyen Residency Program Director and Assistant Professor of Surgery, Chief, Division of Professor of Anesthesia, Beth Israel Deaconess Gastrointestinal Surgery, University of California, Medical Center, Harvard Medical School, MA, Irvine Medical Center, CA, USA USA Alfons Pomp Helen Karakelides Chief, Section of Laparoscopy and Bariatric Assistant Professor of Medicine, Division of Surgery and the Leon C. Hirsch Professor of Endocrinology, Diabetes, Metabolism, New York Surgery, NewYork-Presbyterian Hospital/Weill Presbyterian Hospital, Weill Cornell Medical Cornell Medical College, NY, USA College, NY, USA Silvia E. Perez-Protto Fawzi S. Khayat Resident (Anesthesia), Clereland Clinic Advanced Laparoscopic Fellow, Massachusetts Foundation, OH, USA General Hospital, MA, USA Steve E. Raper Hendrikus J. M. Lemmens Associate Professor of Surgery, University of Professor, Department of Anesthesia, Stanford Pennsylvania Health System, PA, USA University School of Medicine, CA, USA. Roman Schumann Yigal Leykin Director of Clinical Research, Associate Head, Department of Anesthesia and Intensive Professor of Anesthesiology, Tufts University Care , S. Maria degli Angeli Medical Center, School of Medicine, MA, USA Pordenone, Italy Amy Lightner Scott A. Shikora Surgical Resident, UCLA Medical Center, CA, Professor of Surgery, Tufts Medical Center, MA, USA USA Chief, Divisions of General Surgery and Masha Livhits Bariatric Surgery, Tufts Medical Center, MA, USA Surgical Resident, UCLA Medical Center, CA, USA Ashish Sinha Assistant Professor of Anesthesiology and Melinda A. Maggard Critical Care, Assistant Professor of Associate Professor, Department of Surgery, Otorhinolaryngology and Head and Neck UCLA Medical Center, CA, USA Surgery, University of Pennsylvania School of Tracy Martinez Medicine, PA, USA Program Director, Wittgrove Bariatric Center, Brian R. Smith CA, USA Assistant Professor of Surgery, University of John M. Morton California, Irvine Medical Center, CA, USA Associate Professor of Surgery, Section Chief, Chief, General Surgery, VA Healthcare System, Minimally Intensive Surgery, Director of Long Beach, CA, USA viii
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