Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942002000200009
Brazilian Journal of Anesthesiology
Scientific Article

Problemas clínicos pré-anestésicos de pacientes morbidamente obesos submetidos a cirurgias bariátricas: comparação com pacientes não obesos

Preanesthetic clinical problems of morbidly obese patients submitted to bariatric surgery: comparison with non-obese patiens

Getúlio Rodrigues de Oliveira Filho; Tânia Helena Carnieleto Nicolodi; Jorge Hamilton Soares Garcia; Marcos Antônio Nicolodi; Ranulfo Goldschmidt; Adilson José Dal Mago

http://dx.doi.org/10.1590/S0034-70942002000200009 Braz J Anesthesiol, vol.52, n2, p.217-222, 2002
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Resumo

JUSTIFICATIVA E OBJETIVOS: A obesidade mórbida associa-se a problemas clínicos, responsáveis por diminuição da expectativa de vida. Pacientes obesos mórbidos são candidatos a cirurgias bariátricas, impondo novos desafios ao anestesiologista. Este estudo comparou a prevalência de problemas clínicos entre pacientes morbidamente obesos submetidos a cirurgias bariátricas e não obesos submetidos a outros procedimentos eletivos. MÉTODO: Foram estudados, retrospectivamente, os registros eletrônicos de 2986 pacientes divididos em grupo 1, obesos mórbidos submetidos a cirurgias bariátricas e grupo 2, com índice de massa corporal menor que 30, submetidos a outros procedimentos eletivos, relacionados ao grupo 1 pela idade, sexo e estado físico (ASA). Os problemas pré-anestésicos do grupo 1 foram pesquisados no grupo 2 e as prevalências comparadas. As razões de chance (RC) e respectivos limites de 95% de confiança (LC 95%) foram calculados. RESULTADOS: Os problemas identificados nos grupos 1 e 2 e suas respectivas prevalências foram: refluxo gastroesofágico (16,67% e 0,48%), hipertensão arterial sistêmica (50% e 3,06%), diabete melito tipo II (6,25% e 0,31%), hipotireoidismo (6,25% e 0,31%), asma brônquica (10,42% e 1,43%) e pneumopatia restritiva (10,42% e 0,03%). As prevalências foram significativamente mais altas no grupo 1. Foram ainda identificados, no grupo 1, os seguintes problemas que não foram encontrados no grupo 2: epilepsia (2,08%), esteatose hepática (12,5%), colecistopatia calculosa (6,25%), dislipidemia (20,83%) e hipopituitarismo (2,08%). CONCLUSÕES: A prevalência de problemas clínicos é significativamente mais alta em pacientes portadores de obesidade mórbida do que em não obesos de mesma idade, sexo e estado físico.

Palavras-chave

AVALIAÇÃO PRÉ-ANESTÉSICA, CIRURGIA, Abdominal

Abstract

BACKGROUND AND OBJECTIVES: Morbid obesity is associated to clinical problems responsible for decreased life expectancy. Morbidly obese patients are candidates to gastric bypass and pose new challenges to the anesthesiologist. This study compared the prevalence of clinical problems among morbidly obese patients submitted to bariatric surgery to non-obese patients submitted to other elective surgical procedures. METHODS: Electronic records of 2986 patients were retrospectively studied. Patients were divided in two groups; 1: patients with morbid obesity submitted to bariatric surgeries; and group 2: non obese patients (body mass index less than 30 kg.m-2), submitted to other elective surgical procedures. Groups were matched according to age, gender and ASA physical status. Preanesthetic problems common to group 1 were investigated in group 2, and prevalence was compared. Odds ratios and 95% confidence limits were calculated. RESULTS: Clinical problems identified in groups 1 and 2 and their respective prevalence were: gastroesophageal reflux (16.67% and 0.48%), systemic hypertension (50% and 3.06%), type II diabetes mellitus (6.25% and 0.31%), hypothyroidism (6.25% and 0.31%), bronchial asthma (10.42% and 1.43%) and restrictive lung disease (10.42% and 0.03%). Incidences were significantly higher in group 1. Additionally, the following problems were found in group 1, but not in group 2: epilepsy (2.08%), nonalcoholic fatty liver (12.5%), gall bladder stones (6.25%), dyslipemia (20.83%) and hypopytuitarism (2.08%). CONCLUSIONS: The prevalence of clinical problems was significantly higher in morbidly obese patients as compared to their non-obese counterparts.

Keywords

PREANESTHETIC EVALUATION, SURGERY: Abdominal

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