Hairil R Abdullah1, Frances Chung. 1. aDepartment of Anesthesiology, Singapore General Hospital bDuke-NUS Graduate Medical School, Singapore cDepartment of Anesthesiology, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Abstract
PURPOSE OF REVIEW: Incidence of obesity continues to rise and ambulatory surgical centers will need to be prepared for the increase in the obese surgical patients. This review aims to provide recent updates in managing the obese patients in an ambulatory surgical center and to address key clinical questions, such as patient selection, assessment and optimization, as well as important perioperative consideration. RECENT FINDINGS: With low rate of major intraoperative adverse events, obesity has not been associated with unplanned admission after day surgical procedures. There is, however, a higher rate of perioperative adverse events in the super-obese patients. Recent developments in patient assessment include validation of STOP-Bang questionnaire for obstructive sleep apnea in the obese population. Nevertheless, patients with obesity hypoventilation syndrome should be identified and optimized as they are more prone to develop adverse events. The obese patients are also at a higher risk of difficult airway, and recommendations for the airway management are available. SUMMARY: With extra considerations and meticulous perioperative management, it is well tolerated to accept obese patients for ambulatory surgery. The super-obese patients, however, are at a higher risk for perioperative adverse events.
PURPOSE OF REVIEW: Incidence of obesity continues to rise and ambulatory surgical centers will need to be prepared for the increase in the obese surgical patients. This review aims to provide recent updates in managing the obesepatients in an ambulatory surgical center and to address key clinical questions, such as patient selection, assessment and optimization, as well as important perioperative consideration. RECENT FINDINGS: With low rate of major intraoperative adverse events, obesity has not been associated with unplanned admission after day surgical procedures. There is, however, a higher rate of perioperative adverse events in the super-obesepatients. Recent developments in patient assessment include validation of STOP-Bang questionnaire for obstructive sleep apnea in the obese population. Nevertheless, patients with obesity hypoventilation syndrome should be identified and optimized as they are more prone to develop adverse events. The obesepatients are also at a higher risk of difficult airway, and recommendations for the airway management are available. SUMMARY: With extra considerations and meticulous perioperative management, it is well tolerated to accept obesepatients for ambulatory surgery. The super-obesepatients, however, are at a higher risk for perioperative adverse events.