Bariatric anesthesia ladder

Eldawlatly, Abdelazeem

doi:10.4103/1658-354x.152816

Cited by 2 publications

(3 citation statements)

References 2 publications

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“…There are few limited guidelines regarding the perioperative care of OSA patients. [ 9 12 ] Anesthesiologists have practice variations and limited knowledge regarding the perioperative care of OSA patients. [ 10 13 14 ] There are few studies of anesthesiologists' perioperative management of OSA patients; but they are limited in scope, size, reliability and validity.…”

Section: Discussionmentioning

confidence: 99%

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Perioperative care of obstructive sleep apnea patients: A survey of European anesthesiologists

et al. 2021

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Background: Obstructive sleep apnea (OSA) is prevalent in the surgical patient population and is associated with high risk of perioperative complications. There are limited guidelines and wide practice variations regarding the perioperative care of obese and OSA patients. This is a study of European anesthesiologists' clinical practice of perioperative care of OSA patients. Methods: This survey evaluated United Kingdom anesthesiologists' clinical practice of the perioperative care of OSA patients. Outcomes and variables were compared between 4100 anesthesiologists of different clinical experience and hospital settings. Results: Approximately 45% of respondents manage OSA patients rarely, 42% occasionally, and 13% regularly. Most respondents order OSA screening tests if patients have tonsillar hypertrophy, head/neck tumor, BMI >35, increased neck circumference, craniofacial anomaly, and right-sided electrocardiography (ECG) anomaly. Majority request preoperative polysomnography, ECG, overnight pulse oximetry, and arterial blood gas analysis. Majority recommend preoperative weight loss, optimisation, smoking cessation, reduction of substance use, and regular mask-CPAP use. Majority consider endoscopy, and ophthalmology as appropriate day case procedures, but not laparoscopy. Majority postpone elective airway, laparoscopic, laparotomy, and head/neck surgery; if patients are not optimized preoperatively. For major surgery, combined general + neuraxial anesthesia was ranked as 3 rd option. For major limb surgery, neuraxial anesthesia without sedation was ranked as 1 st option, nerve block without sedation was ranked 2 nd , and general anesthesia + nerve block was ranked 3 rd or 4 th . At anesthesia emergence, majority ensure that patients have normal consciousness, respiration and neuromuscular function. Majority ensure postoperative oximetry, telemetry, and oxygen supplementation. Conclusion: This study highlights variations in anesthesiologists' perioperative care of OSA patients; even in developed countries with advanced medical training and standards. The study outcomes will improve perioperative care of OSA patients.

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Section: Discussionmentioning

confidence: 99%

“…These findings corroborate recent evidence, and highlight that general anesthesia should be avoided if possible. [ 9 12 13 ] Nerve block, as sole anesthesia, was ranked as 2 nd choice by most anesthesiologists; and this is a unique finding that requires exploration.…”

Section: Discussionmentioning

confidence: 99%

Perioperative care of obstructive sleep apnea patients: A survey of European anesthesiologists

et al. 2021

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“…Later, in 1990, the WHO extended the analgesic ladder to include pain management in pediatric patients with cancer. Since then, the WHO analgesic ladder has become a standard guideline for pain management in pediatric and adult patients worldwide [8].…”

Section: Treatment Of Postoperative Pain In Pediatricsmentioning

confidence: 99%

Postoperative Pain in Pediatrics

Escalona-Espinosa,

Maldonado-Sánchez,

Pazos-Alvarado

et al. 2023

Topics in Postoperative Pain

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Postoperative pain in pediatrics is a common concern for both parents and healthcare professionals. Children who experience pain after surgery can present with several complications, including nausea, vomiting, breathing difficulties, sleep disturbances, and decreased physical activity. In addition, untreated pain can have long-term effects on children’s emotional and psychological well-being. It is important to recognize that children may experience pain differently than adults and, therefore, need a personalized treatment approach. Evaluation and management of postoperative pain in pediatrics should be based on the child’s age, the type of surgery, and the severity of pain. Several treatment options are available, including oral, intravenous, and epidural analgesics, as well as non-pharmacological techniques such as relaxation and distraction. Prevention of postoperative pain is also important and can be achieved through the administration of analgesics prior to surgery and early postoperative care.

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Bariatric anesthesia ladder

Cited by 2 publications

References 2 publications

Perioperative care of obstructive sleep apnea patients: A survey of European anesthesiologists

Perioperative care of obstructive sleep apnea patients: A survey of European anesthesiologists

Postoperative Pain in Pediatrics

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