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Chapter 23 - Care of the Bariatric Patient

Published online by Cambridge University Press:  18 August 2022

By
Hannah Abbott
Edited by
Daniel Rodger ,
Kevin Henshaw ,
Paul Rawling  and
Scott Miller
Daniel Rodger
Affiliation:
Senior Lecturer in Perioperative Practice, London South Bank University
Kevin Henshaw
Affiliation:
Associate Head of Allied Health Professions, Edge Hill University, Ormskirk
Paul Rawling
Affiliation:
Senior Lecturer in Perioperative Practice, Edge Hill University, Ormskirk
Scott Miller
Affiliation:
Consultant Anaesthetist, St Helens and Knowsley Hospitals NHS Trust
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Summary

This chapter explains the challenges involved with bariatric surgery and how they can be navigated to optimise patient care. Due to the increasing global rates of obesity, increasing numbers of bariatric patients are presenting for surgery. Obesity is associated with several physiological and psychological effects, and it is essential that these are considered in order to plan and deliver safe, effective, patient-centred perioperative care.

Keywords

ObesityBariatricCardiovascularMorbidityWeightPhysiologyDiabetesAnaesthesiaPatient positioningManual handling
Type
Chapter
Information
Fundamentals of Operating Department Practice , pp. 255 - 263
Publisher: Cambridge University Press
Print publication year: 2022

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References

Rush, A.. Bariatric care: pressure ulcer prevention. Wound Essentials 2009; 4: 68–74.Google Scholar
Wold Health Organization. Obesity and overweight. Available from: www.who.int/news-room/fact-sheets/detail/obesity-and-overweight (accessed June 2020).Google Scholar
NHS Digital. Statistics on obesity, physical activity and diet, England, 2020. Available from: https://digital.nhs.uk/data-and-information/publications/statistical/statistics-on-obesity-physical-activity-and-diet/england-2020.Google Scholar
World Health Organization Regional Office for Europe. Body mass index: BMI. Available from: www.euro.who.int/en/health-topics/disease-prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi (accessed June 2020).Google Scholar
Society for Obesity and Bariatric Anaesthesia. Anaesthesia for the obese patient (SOBA single-sheet guideline). Available from: www.sobauk.co.uk/guidelines-1.Google Scholar
Ortiz, V. E. and Kwo, J.. Obesity: physiologic changes and implications for preoperative management. BMC Anesthesiology 2015; 15: 97–109.Google Scholar
Association of Anaesthetists of Great Britain and Ireland. Peri-operative management of the obese surgical patient 2015. Anaesthesia 2015; 70: 859–879.Google Scholar
Chung, F., Yang, Y., and Liao, P.. Predictive performance of the STOP-Bang score for identifying obstructive sleep apnea in obese patients. Obesity Surgery 2013; 23: 2050–2057.Google Scholar
Toronto Western Hospital. STOP-Bang questionnaire. Available from: www.stopbang.ca (accessed June 2020).Google Scholar
National Institute for Health and Care Excellence. Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism. Available from: www.nice.org.uk/guidance/ng89/chapter/recommendations.Google Scholar
Abbott, H.. Laparaoscopic adjustable gastric band; the care of Chloe Brown. In Abbott, H. and Wordsworth, S. (eds.), Perioperative Practice Case Book. London: Open University Press, 2016, pp. 167–176.Google Scholar
Abbott, H.. Perioperative assessment. In Abbott, H. and Ranson, M. (eds.), Clinical Examination Skills for Healthcare Professionals, 2nd ed. Keswick: M&K Publishing, 2017, pp. 171–192.Google Scholar
Gould, M. K., Garcia, D. A., Wren, S. M., et al. Prevention of VTE in nonorthopedic surgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141: e227S.CrossRefGoogle ScholarPubMed
Raftopoulos, I., Martindale, C., Cronin, A., et al. The effect of extended post-discharge chemical thromboprophylaxis on venous thromboembolism rates after bariatric surgery: a prospective comparison trial. Surgical Endoscopy 2008; 22: 2384–2391.Google Scholar
Subharwal, A. and Christelis, N.. Anaesthesia for bariatric surgery. Continuing Education in Anaesthesia 2010; 10: 99–103.Google Scholar
Lundstrfm, L. H., Mfller, A. M., Rosenstock, C., et al. High body mass index is a weak predictor for difficult and failed tracheal intubation: a cohort study of 91,332 consecutive patients scheduled for direct laryngoscopy registered in the Danish Anesthesia Database. Anesthesiology 2009; 110: 266–274.CrossRefGoogle Scholar
Brodsky, J. B., Lemmens, H. J. M., Brock-Utne, J. G., et al. Morbid obesity and tracheal intubation. Anesthesia and Analgesia 2002; 94: 732–736.CrossRefGoogle ScholarPubMed
Crawley, S. M. and Dalton, A. J.. Predicting the difficult airway. BJA Education 2015; 15: 253–257.CrossRefGoogle Scholar
Javid, M. J.. Examination of submental space as an alternative method of airway assessment (submental sign). BMC Research Notes 2011; 4: 221.Google Scholar
Hamza, J., Smida, M., Benhamou, D., et al. Parturient’s posture during epidural puncture affects the distance from the skin to the epidural space. Journal of Clinical Anesthesia 1995: 7: 1–4Google Scholar
Ingrande, J., Brodsky, J. B., and Lemmens, H. J. M.. Lean body weight scalar for the anesthetic induction dose of propofol in morbidly obese subjects. Anesthesia and Analgesia 2011; 113: 57–62.CrossRefGoogle ScholarPubMed
Vallejo, M. C., Sah, N., Phelps, A. L., et al. Desflurane versus sevoflurane for laparoscopic gastroplasty in morbidly obese patients. Journal of Clinical Anaesthesia 2007; 19: 3–8.Google Scholar
Health and Safety Executive. Risk assessment and process planning for bariatric patient handling pathways. Available from: www.hse.gov.uk/research/rrpdf/rr573.pdf.Google Scholar

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