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Anesthesia for Weight Reduction Surgery

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Anesthesiology

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Abstract

Obesity is a growing problem in the United States, affecting over a third of the adult population. Excess body weight has implications for nearly every organ system, increasing the risk of life-altering comorbidities including heart disease, respiratory dysfunction, diabetes, cancer, and musculoskeletal injury. Bariatric surgery offers patients surgical rearrangement of the gastrointestinal tract, causing caloric malabsorption, restriction, or both. Patients lose more weight, sustain greater weight loss, and experience better comorbidity reduction compared to medical management. The anesthesia team plays a critical role in achieving successful perioperative outcomes. Understanding the technical surgical approaches allows one to facilitate the procedure and anticipate complications. Special attention to airway management, cardiopulmonary physiology of obesity, and patient positioning mitigates the risks of anesthesia in the obese. Thorough knowledge of pharmacology and its application to the obese is critical to appropriately apply total, lean, or ideal body-weight calculations and achieve therapeutic drug levels. By learning the advances in surgical technique and appreciating the perioperative implications of obesity, one can effectively coordinate with the surgical team and contribute to successful perioperative outcomes.

Illustrations by Angelo Andonakakis D.O.

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Notes

  1. 1.

    Multiple formulas exist for each calculation, though they share relative agreement.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, Cooper University Hospital, Camden, NJ, USA

    Angelo Andonakakis D.O. & Kathleen Kwiatt D.O.

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  1. Angelo Andonakakis D.O.
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  2. Kathleen Kwiatt D.O.
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Editors and Affiliations

  1. Hospital University Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA

    Basavana G. Goudra

  2. Department of Anesthesiology, Emory University, Atlanta, Georgia, USA

    Michael Duggan

  3. Department of Anesthesiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA

    Vidya Chidambaran

  4. University Hospitals Birmingham, Birmingham, United Kingdom

    Hari Prasad Krovvidi Venkata

  5. Emory University Hospital, Atlanta, Georgia, USA

    Elizabeth Duggan

  6. University of Alabama at Birmingham, Birmingham, Alabama, USA

    Mark Powell

  7. All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India

    Preet Mohinder Singh

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Andonakakis, A., Kwiatt, K. (2018). Anesthesia for Weight Reduction Surgery. In: Goudra, B., et al. Anesthesiology. Springer, Cham. https://doi.org/10.1007/978-3-319-74766-8_81

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  • DOI: https://doi.org/10.1007/978-3-319-74766-8_81

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