Nitrous Oxide and Laparoscopic Bariatric Surgery

Brodsky, Jay B.; Lemmens, Harry J. M.; Collins, Jeremy; Morton, John; Curet, Myriam J.; Brock‐Utne, John G.

doi:10.1381/0960892053723286

Cited by 23 publications

(9 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Maintenance of anesthesia . Although there are measurable differences in recovery profiles after use of different general anesthetic techniques or agents, including nitrous oxide, they do not result in clinically relevant outcome improvements for patients undergoing open or laparoscopic WLS (28,29,30,31,32,33,34).…”

Section: Resultsmentioning

confidence: 99%

Update on Best Practice Recommendations for Anesthetic Perioperative Care and Pain Management in Weight Loss Surgery, 2004–2007

Schumann

Jones

Cooper

et al. 2009

Obesity

View full text Add to dashboard Cite

To reevaluate and update evidence‐based best practice recommendations published in 2004 for anesthetic perioperative care and pain management in weight loss surgery (WLS), we performed a systematic search of English‐language literature on anesthetic perioperative care and pain management in WLS published between April 2004 and May 2007 in MEDLINE and the Cochrane Library. We identified relevant abstracts by using key words, retrieved full text articles, and stratified the resulting evidence according to systems used in established evidence‐based models. We updated prior evidence‐based best practice recommendations based upon interim literature. In instances of controversial or inadequate scientific evidence, the task force reached consensus recommendations following evaluation of the best available information and expert opinion. The search yielded 1,788 abstracts, with 162 potentially relevant titles; 45 were reviewed in detail. Despite more information on perioperative management of patients with obstructive sleep apnea (OSA), evidence to support preoperative testing and treatment or to guide perioperative monitoring is scarce. New evidence on appropriate intraoperative dosing of muscle relaxants allows for greater precision in their use during WLS. A novel application of α−2 agonists for perioperative anesthetic care is emerging. Key elements that may enhance patient safety include integration of the latest evidence on WLS, obesity, and collaborative multidisciplinary care into clinical care. However, large gaps remain in the evidence base.

show abstract

Section: Resultsmentioning

confidence: 99%

Update on Best Practice Recommendations for Anesthetic Perioperative Care and Pain Management in Weight Loss Surgery, 2004–2007

Schumann

Jones

Cooper

et al. 2009

Obesity

View full text Add to dashboard Cite

show abstract

“…45 In a smaller study, laparoscopic surgeons operating on morbidly obese patients could not tell whether the patient was receiving N 2 O as part of the anaesthetic. 46 During laparoscopy, the abdomen is inflated with gas, usually carbon dioxide. Although N 2 O reportedly carries a danger of explosion if it is mixed with hydrogen from intestinal gas, 47 this is untrue.…”

Section: Gastrointestinal Effectsmentioning

confidence: 99%

The adverse effects of nitrous oxide

Ferner

Mackenzie²,

Aronson³

2014

Adverse Drug Reaction Bulletin

View full text Add to dashboard Cite

“…Nitrous oxide (N 2 O) can be used because it is not liposoluble, has a fast onset of action, and early awakening; sometimes its use in obese patients is limited due to the increased O 2 consumption. Brodsky et al used general anesthesia with nitrous oxide and verified that this gas does not disturb the surgeon during videolaparoscopic bariatric surgery 74 . Most intravenous anesthetics are strongly lipophilic, with an increased volume of distribution (VD) in obese patients.…”

Section: Anesthetic Techniquementioning

confidence: 99%

“…O óxido nitroso (N 2 O) pode ser usado por ser insolúvel em gorduras, ter rápido início de ação e despertar precoce; às vezes, o seu uso fica limitado por causa do aumento do consumo de O 2 em obesos. Brodsky e col. realizaram anestesia geral com óxido nitroso e verificaram que este gás não atrapalhava o cirurgião durante intervenção cirúrgica bariátrica videolaparoscópica 74 . A maioria dos anestésicos venosos é fortemente lipofílica e apresenta volume de distribuição (VD) aumentado em obesos; logo, suas doses devem ter como base o peso corporal corrigido, sendo exceções a procainamida, a digoxina e o remifentanil que, mesmo sendo lipofílicos, podem ter suas doses calculadas pelo peso corporal ideal.…”

Section: Técnica Anestésicaunclassified

Anestesia para obesidade mórbida

Lorentz¹,

Albergaria²,

Lima³

2007

Rev. Bras. Anestesiol.

View full text Add to dashboard Cite

RESUMOLorentz MN, Albergaria VF, Lima FAS -Anestesia para Obesidade Mórbida. JUSTIFICATIVA E OBJETIVOS:A obesidade mórbida é uma doença muito freqüente em nosso meio, enquanto nos EUA já assumiu caráter epidêmico. O paciente obeso apresenta uma série de alterações fisiopatológicas, além de importantes comorbidades, o que exige do anestesiologista pleno conhecimento da fisiopatologia da doença. O procedimento cirúrgico de redução gástrica tem sido cada vez mais realizado e o período perioperatório apresenta características únicas com alterações cardiovascular e pulmonar que o tornam um verdadeiro desafio para os profissionais envolvidos. O hospital também deve estar preparado para receber esses pacientes, com equipamentos adequados, equipe multidisciplinar e cuidados pós-operatórios. O objetivo deste estudo foi demonstrar que o paciente obeso mórbido não é apenas um paciente com excesso de peso, e, portanto, procurou-se nortear as principais condutas a serem observadas.CONTEÚDO: São apresentadas neste artigo as principais alterações fisiopatológicas do obeso mórbido, bem como dados de epidemiologia e doenças correlacionadas. É realizada uma revisão das doses dos medicamentos usados na anestesia, bem como a melhor abordagem pré-, intra-e pós-operatória pelo anestesiologista. CONCLUSÕES:A abordagem do paciente com obesidade mórbida exige um planejamento minucioso que se inicia na seleção dos pacientes, tem continuidade com pré-operatório detalhado e intraoperatório individualizado, e se estende até o pós-operatório, quando a incidência de complicações pulmonar, cardiovascular e infecciosa é maior que na população não-obesa. Para que os resultados sejam favoráveis é extremamente importante o envolvimento de uma equipe multiprofissional que inclui Clínica Geral, Anestesiologia, Cirurgia Geral, Enfermagem, Psicologia, Fisioterapia, Nutrologia e Terapia Intensiva.Unitermos: CIRURGIA, Abdominal: bariátrica; DOENÇAS, Obesidade: mórbida. SUMMARYLorentz MN, Albergaria VF, Lima FAS -Anesthesia for Morbid Obesity. BACKGROUND AND OBJECTIVES:Morbid obesity is very frequent in our society, having achieved the level of an epidemic in the United States. Obese patients present several physiopathologic changes and important comorbidities, which the anesthesiologist must be aware of. Gastric reduction surgery is increasingly more frequent, and the perioperative period has unique characteristics, with cardiovascular and pulmonary changes that make it a real challenge for the professional involved. The hospital should also be prepared to receive those patients, with adequate equipment, a multidisciplinary team, and postoperative care. The objective of this study was to demonstrate that the patient with morbid obesity is not only a person with weight excess and, therefore, we attempted to describe the main conducts to be followed. CONTENTS:Here we present the main physiopathologic changes in the patient with morbid obesity, as well as the epidemiological data and correlated diseases. We review the doses of the drugs used in anesthesia,...

show abstract

Nitrous Oxide and Laparoscopic Bariatric Surgery

Abstract: We found that using N2O did not cause noticeable bowel distention during laparoscopic bariatric procedures of relatively short duration.

Cited by 23 publications

References 10 publications

Update on Best Practice Recommendations for Anesthetic Perioperative Care and Pain Management in Weight Loss Surgery, 2004–2007

Update on Best Practice Recommendations for Anesthetic Perioperative Care and Pain Management in Weight Loss Surgery, 2004–2007

The adverse effects of nitrous oxide

Anestesia para obesidade mórbida

Contact Info

Product

Resources

About