Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942003000200010
Brazilian Journal of Anesthesiology
Miscellaneous

Desafios no manuseio peri-operatório de pacientes obesos mórbidos: como prevenir complicações

Challenges in perioperative management of morbidly obese patients: how to prevent complications

José Otávio Costa Auler Junior; Cindy Galvão Giannini; Daniel Fernandes Saragiotto

http://dx.doi.org/10.1590/S0034-70942003000200010 Braz J Anesthesiol, vol.53, n2, p.227-236, 2003
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Resumo

JUSTIFICATIVA E OBJETIVOS: A incidência de Obesidade Mórbida tem aumentado significativamente nas últimas décadas, especialmente nos países desenvolvidos. Os excelentes resultados observados com o tratamento cirúrgico desta condição têm feito ressurgir o interesse no manuseio anestésico deste grupo de pacientes. O objetivo deste estudo foi enfatizar pontos vitais para o anestesiologista que lida com tais pacientes. CONTEÚDO: Distúrbios cardiovasculares, respiratórios, endócrinos e metabólicos são freqüentemente associados à obesidade e podem causar repercussões de significado clínico importantes no período peri-operatório nestes pacientes. Alguns aspectos de interesse prático à anestesia são discutidos nesta revisão. CONCLUSÕES: Além da ênfase dada às complicações mais importantes e mais freqüentemente observadas e de como preveni-las, destacamos também a importância do uso do PEEP e de volumes correntes adequados, recomendando seu uso.

Palavras-chave

ANESTESIA, CIRURGIA, CIRURGIA, DOENÇAS

Abstract

BACKGROUND AND OBJECTIVES: The incidence of morbid obesity has significantly increased in recent years, especially in developed countries. Excellent results of the surgical treatment of such condition have raised the interest in the anesthetic management of such patients. This study aimed at emphasizing critical issues for anesthesiologists dealing with morbidly obese patients. CONTENTS: Cardiovascular, respiratory, endocrine and metabolic changes have been frequently associated to obesity and may cause significant clinical repercussions in the perioperative period of such patients. Some practical anesthetic issues are discussed in this review. CONCLUSIONS: In addition to emphasizing most significant and frequent complications and their prevention, the importance of PEEP and adequate tidal volumes is also highlighted.

Keywords

ANESTHESIA, DISEASES, SURGERY, SURGERY

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