Regional anesthesia in adult patients with obesity

Translated title of the contribution: Regional anesthesia in adult patients with obesity

Research output: Contribution to journalReview articlepeer-review

Abstract

Obesity is one of the important public health concerns, and described as abnormal accumulation of fat. It is associated with cardiopulmonary physiological alterations and a number of comorbidities (obstructive sleep apnea, metabolic syndrome, coronary artery disease…). Not only surgical and anesthetic managements of obese patients are challenging but also their perioperative morbidity and mortality rates are higher. We, as anesthesiologists, face these patients at an increasing rate with time. Since we prefer regional anesthesia techniques to general anesthesia in appropriate surgery types; we would avoid airway manipulations, opioid consumption and surgery-related stress responses. Regional anesthesia techniques are attractive options; however, they have unique challenges such as requirement for special equipment, crucial positioning, multiple attempts at redirecting needle/catheter, difficulty in palpation of anatomical landmarks, and increased rate of failed blocks in patients with obesity. Ultrasound-guidance provides us visualization of anatomical structures, decreased rates of needle insertions, and orientations, procedural trauma, side effects/complications and increased rates of block success. This review focuses on the obesity-related comorbidities; possible problems occur during the performance of neuroaxial, upper extremity, lower extremity, thoracic and abdominal wall block techniques performed on obese patients; literature supported suggestions and the role of ultrasound to manage these situations.

Translated title of the contributionRegional anesthesia in adult patients with obesity
Original languageEnglish
Pages (from-to)219-230
Number of pages12
JournalAnestezi Dergisi
Volume29
Issue number1
DOIs
StatePublished - 2021

Keywords

  • Body mass index
  • Neuroaxial anesthesia
  • Obesity
  • Peripheral nerve blocks
  • Regional anesthesia

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