ANESTHESIOLOGY FAST REVIEW

ANESTHESIOLOGY_FAST_REVIEWKAPAK1-0-25

ANESTHESIA Of BARIATRIC SURGERY

İsmail Arslan

Sinop Atatürk State Hospital, Department of Anesthesiology and Reanimation, Sinop, Türkiye

Arslan İ. Anesthesia of Bariatric Surgery. In: Kazancı D, editor. Anesthesiology Fast Review. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.441-453.

ABSTRACT

  • The origin of obesity dates back to the first humans.In 2022, 2.5 billion adults over the age of 18 were identified as overweight. 890 million of them were struggling with obesity.
  • The main cause of obesity is seen as unbalanced nutrition and lack of exercise. However, it can also be seen as a result of biological, environmental and behavioral reasons.
  • Obese patients with additional diseases such as coronary artery disease, peripheral artery disease, type 2 diabetes, and sleep apnea are placed in the category of increased risk of death.
  • Obesity alters respiratory mechanics through effects such as increased respiratory workload, decreased functional residual capacity (FRC), airway hyperreactivity, and increased obstructive sleep apnea OSA count compared to people with a normal BMI value.
  • Studies have shown that the combined application of bariatric surgery and drug therapy is more beneficial metabolically and reduces postoperative gastrointestinal symptoms.
  • Sleeve gastrectomy (SG) is the most commonly used surgical approach in obesity surgery in the current approach. Fewer complications are seen in SG compared to different approaches applied in obesity surgery.
  • Lots of studies have found that obesity increases the probability of difficult mask ventilation.Anesthesiologists must make detailed preoperative evaluations and be prepared for difficult airways.
  • The distribution volume of drugs with high lipophilic properties increases in obesity.
  • The head-up position is generally used in obesity surgery. This position facilitates cardiac output, airway management, ventilation and oxygenation in obese patients.
  • A multimodal approach should be applied for pain control. The aim of the multimodal analgesic approach is to reduce the amount of opioids and minimize the possibility of respiratory depression.

Keywords: Obesity; Bariatric surgery; Difficult airway; Positon; BMI

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