Obesity and day-case surgery

Davies, K.; Houghton, Kristin; Montgomery, J. E.

doi:10.1046/j.1365-2044.2001.01962-5.x

Cited by 48 publications

(17 citation statements)

References 2 publications

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“…There was no difference between the unplanned admission rate for a BMI > 35 kg·m -2 and a BMI < 35 kg·m -2 . 37 There were no significant differences between the two groups with regard to unplanned contact with healthcare professionals after discharge. 37 Three other large observational studies evaluating the outcomes of over 800,000 patients undergoing ambulatory surgery could find no association between obesity and unanticipated admission.…”

Section: Are the Obese At An Increased Risk Of Unanticipated Hospitalmentioning

confidence: 84%

“…37 There were no significant differences between the two groups with regard to unplanned contact with healthcare professionals after discharge. 37 Three other large observational studies evaluating the outcomes of over 800,000 patients undergoing ambulatory surgery could find no association between obesity and unanticipated admission. 11,12,38 There is no evidence that obesity alone contributes to unanticipated admissions following ambulatory surgery (grade A).…”

Section: Are the Obese At An Increased Risk Of Unanticipated Hospitalmentioning

confidence: 84%

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Patient selection in ambulatory anesthesia — An evidence-based review: part II

et al. 2004

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P Pu ur rp po os se e: : This is the second of two reviews evaluating the management of patients with selected medical conditions undergoing ambulatory anesthesia and surgery. Conditions highlighted in this review include: diabetes mellitus; morbid obesity; the ex-premature infant; the child with an upper respiratory infection; malignant hyperthermia; and the use of monoamine oxidase inhibitors.S So ou ur rc ce e: : Medline search strategies and the framework for the evaluation of clinical evidence are presented in Part I. P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : Diabetes mellitus has not been linked with adverse events following ambulatory surgery. The morbidly obese patient is at an increased risk for minor respiratory complications in the perioperative period but these events do not increase unanticipated admissions. The ex-premature infant may be considered for ambulatory surgery if post-conceptual age is > 60 weeks and hematocrit is > 30%. The child with a recent upper respiratory tract infection is at an increased risk for perioperative respiratory complications, particularly if endotracheal intubation is required. Patients with malignant hyperthermia may undergo outpatient surgery but require four hours of postoperative temperature monitoring. Sporadic cases of drug interactions have been reported when meperidine and indirectacting catecholamines are administered in the presence of monamine oxidase inhibitors. Ambulatory anesthesia and surgery is safe if these combinations of drugs are avoided.C Co on nc cl lu us si io on n: : Ambulatory anesthesia can be performed in, and is being offered to, a variety of patients with significant coexistent disease. In many cases there is little evidence documenting the outcomes expected in such patients. Prospective observational and interventional trials are required to better define perioperative management. Objectif : C'est la seconde revue qui évalue la prise en charge de patients, dont les pathologies médicales ont été ciblées, qui doivent subir une anesthésie en chirurgie ambulatoire. Les situations choisies comprennent : le diabète, l'obésité morbide, l'enfant né prématurément, l'enfant atteint d'infection des voies respiratoires supérieures, l'hyperthermie maligne et l'usage d'inhibiteurs de la monoamine-oxydase. Source : Les stratégies de recherche dans Medline et le cadre de l'é-valuation de la preuve clinique sont présentés dans la partie I. Constatations principales : Le diabète n'a pas été relié à des événements indésirables à la suite d'une opération ambulatoire. Le patient très obèse est plus à risque de complications respiratoires péri-opératoires mineures, ce qui n'augmente pas les admissions hospitalières imprévues. L'enfant prématuré est admis en chirurgie ambulatoire si l'âge post-conception est > 60 semaines et si l'hématocrite est > 30 %. L'enfant qui a une infection récente des voies respiratoires supérieures

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Section: Are the Obese At An Increased Risk Of Unanticipated Hospitalmentioning

confidence: 84%

Section: Are the Obese At An Increased Risk Of Unanticipated Hospitalmentioning

confidence: 84%

Patient selection in ambulatory anesthesia — An evidence-based review: part II

et al. 2004

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“…10 In a cohort of 55,538 orthopedic patients, OSA was associated with increased risks of aspiration pneumonia (OR 1.41; 95% CI 1.35 to 1.47); adult respiratory distress syndrome (OR 2.39; 95% 4). 11 An earlier systematic review also suggested an association between OSA and adverse events in the perioperative period. 5 What could be responsible for the disparate findings in our population?…”

Section: Discussionmentioning

confidence: 99%

“…Obesity has been associated with oxygen desaturation in those with and without OSA 20 ; however, obesity has not been associated with increased admissions following ambulatory surgery. 11,21 Higher rates of unplanned admission at the inpatient centres could reflect a population at higher medical and / or surgical risk. It is equally likely that access to 23-hr stay units at the Civic and General Campuses offered a lower threshold for admission.…”

Section: Discussionmentioning

confidence: 99%

Unplanned admission after day surgery: A historical cohort study in patients with obstructive sleep apnea

Bryson

Gómez

Jee

et al. 2012

Can J Anesth/J Can Anesth

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“…8 A study of 258 morbidly obese patients undergoing ambulatory surgery did not reveal any significant increase in unplanned admissions or complications. 9 With the prevalence of obesity increasing worldwide, clear and current guidelines need to be formulated. 10 Obstructive sleep apnea in the ambulatory surgery setting has become a more significant concern in recent years, being a critical part of preoperative patients' risk assessment.…”

Section: Résultats : Nous Avons Reçu 774 Réponses Pour Les 1 337 Quesmentioning

confidence: 99%

Ambulatory surgery adult patient selection criteria — a survey of Canadian anesthesiologists

Friedman

Chung

Wong

2004

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : An increasing number of patients with complex medical problems are now considered suitable for ambulatory surgery. The purpose of this study was to identify the current clinical practice of ambulatory surgical patient selection. M Me et th ho od ds s: :A standardized questionnaire specifying 30 clinical conditions was sent to all practicing anesthesiologists who are members of the Canadian Anesthesiologists' Society. Recipients were asked to indicate if they would provide ambulatory anesthesia (yes/no answers) for an adult patient with each of those isolated conditions. A 75% agreement was considered a majority opinion.R Re es su ul lt ts s: : One thousand three hundred thirty-seven questionnaires were sent and 774 replies were received (57.8%). Over 75% of anesthesiologists were willing to include in their selection criteria American Society of Anesthesiologists' (ASA) physical status III, patients with low-grade angina pectoris (AP) and congestive heart failure (CHF), prior myocardial infarction, asymptomatic valvular disease, sleep apnea without use of narcotics, morbid obesity (MO) without co-morbidities, insulin dependent diabetes mellitus and malignant hyperthermia (MH) susceptible patients. Over 75% of responders found ASA IV patients, high grade AP and CHF, sleep apnea with postoperative narcotics, MO with co-morbidities and no patient escort to be unsuitable for ambulatory anesthesia.C Co on nc cl lu us si io on n: : Our survey demonstrated that medical conditions with extreme grades of severity (mild or severe) are associated with majority opinion to proceed or not to proceed with ambulatory surgery. Issues with over 75% agreement reflect the common practice. Similar surveys may form a part of patient selection guidelines development in the future. Objectif

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Obesity and day-case surgery

Cited by 48 publications

References 2 publications

Patient selection in ambulatory anesthesia — An evidence-based review: part II

Patient selection in ambulatory anesthesia — An evidence-based review: part II

Unplanned admission after day surgery: A historical cohort study in patients with obstructive sleep apnea

Ambulatory surgery adult patient selection criteria — a survey of Canadian anesthesiologists

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