Obezite ve Anestezi
Synopsis
Obesity, defined by the World Health Organization as an abnormal or excessive accumulation of fat that poses health risks, presents a high-risk scenario that directly complicates anesthetic management through the pathophysiological changes it causes across bodily systems. Classified by Body Mass Index (BMI) and waist circumference measurements, obesity leads to significant dysfunction in the cardiovascular, respiratory, endocrine, urogenital, and gastrointestinal systems. Anatomical factors such as fat accumulation in the airway, a short neck, and restricted mobility increase the incidence of difficult mask ventilation and tracheal intubation. Furthermore, decreased functional residual capacity and lung compliance cause rapid oxygen desaturation during apnea periods. Due to changes in drug distribution volume and clearance, dosages of anesthetic agents and neuromuscular blockers must be meticulously calculated based on Ideal Body Weight (IBW) or Lean Body Weight (LBW). Preoperative evaluation requires detailed screening for comorbidities, sleep apnea, and thromboembolism risk, while intraoperative management should utilize the ramp position, appropriate PEEP, and lung-protective ventilation strategies. Finally, postoperative care aims to prevent potential atelectasis, hypoxia, and cardiac complications through multimodal analgesia, early mobilization, proper positioning, and respiratory support.
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http://www.who.int/mediacentre/factsheets/fs311/en/, erişim tarihi: 04.11. 2013
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