Bronchospasm in obese patients undergoing elective laparoscopic surgery under general anesthesia
| Autor: | George Vretzakis, Argyro Petsiti, Hronis Ieropoulos, Menelaos Karanikolas, Aik Bouzia, Elias Mantoudis, Vassilios Tassoudis |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Laparoscopic surgery
Complications medicine.medical_treatment 030204 cardiovascular system & hematology Bronchospasm 03 medical and health sciences 0302 clinical medicine medicine Obesity Mechanical ventilation Bariatric surgery Multidisciplinary business.industry Incidence (epidemiology) Research Repeated measures design respiratory system Hypoventilation respiratory tract diseases Airway 030228 respiratory system Oxygenation Anesthesia Anesthetic medicine.symptom business medicine.drug |
| Zdroj: | SpringerPlus |
| ISSN: | 2193-1801 |
| Popis: | Background Existing data suggest that obesity correlates with airway hyper-reactivity. However, the incidence of bronchospasm during bariatric surgery in obese patients has not been well studied. Methods This was a prospective observational study comparing 50 obese versus 50 non obese patients undergoing elective laparoscopic surgery over a 2 year period. Bronchospasm was detected clinically by auscultation and was confirmed by measuring peak airway pressure during mechanical ventilation. Blood gases were measured at predetermined time intervals intraoperatively. Categorical variables were analyzed using Fisher’s exact test, while numerical variables within and between groups were compared using repeated measures general linear model. Results The incidence of bronchospasm was significantly higher in obese compared to non obese patients (P = 0.027). Peak airway pressures and blood gases differed significantly when comparing non obese patients versus obese patients without bronchospasm versus obese patients with bronchospasm. Hypoventilation resulting in gradual increase of arterial PaCO2 was noted in all groups during surgery. Conclusion The incidence of bronchospasm is higher in obese patients compared to non obese patients undergoing elective laparoscopic surgery. Airway pressures and blood gas values in obese patients are somewhere between values in non obese patients and values in patients with bronchospasm, thereby implying that obesity is associated with a state where bronchial smooth muscles are not fully relaxed. Consideration of increased airway reactivity in obese patients undergoing laparoscopic surgery is important for improved patient care and uneventful anesthetic course. |
| Databáze: | OpenAIRE |
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