Pheochromocytoma presents a challenge to the surgery team because of its clinical features and implications. The patient must be treated before the surgery until a stable hemodynamically state is achieved. The preoperative treatment includes α2-short acting adrenergic blocking and β-blocker agents. The most crucial intraoperative moments are induction of anesthesia and hemodynamic oscillations. An adequate preoperative preparation, modern anesthetic drugs, good collaboration between the surgeons and the anesthesiologists, and postoperative care decrease the rate of complications and improve the outcome. This review aims to discuss all the possible pharmacological strategies of perioperative management of phoechromocytoma, focusing on new drugs and treatments.
O besity is now rampant at epidemic levels and is associated with many known serious problems, not the least of which is the issue of managing anesthesia for obese patients. This review article examines and assesses the most important of these anesthetic challenges.Obesity, morbid obesity, and supermorbid obesity are defined as body mass indexes (BMIs) of 30 kg/m 2 or greater, 35 kg/m 2 or greater, and 55 kg/m 2 or greater, respectively. The
Postoperative Delirium occurs as a result of the combination of several factors, not just those related to internal physiological age, but combining of these factors with the diseases which carries this age, with medications used for this age, with surgical stress, with biochemical imbalances, hemodynamic problems, and electrolytic disorders as well.
Obesity seems to be the modern concern to society. An increasing number of obese patients present annually to surgical wards to undergo surgical procedures. As morbid obesity affects most of the vital organs, the anesthesiologist must be prepared to deal with several challenges. These include the preoperative evaluation of the consequences of obesity, particularly on cardiac, respiratory, and metabolic systems; airway management; different pharmacokinetic and pharmacodynamic drug regimen; and perioperative management (i.e., hemodynamic, respiratory, and hyperglycemic). This paper reviews and assesses the most important anesthetic issues in managing obese patients.
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