Comparative Study Between Neostigmine Versus Sugammadex in Obese Patients Undergoing Laparoscopic Surgery

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed A Zaghlol ◽  
Alfred M Boctor ◽  
Hadyl M Abd-Elhamed ◽  
Ahmed A Abd-Elhak ◽  
Ramadan R Bakheat
Keyword(s):  
Armed Forces ◽  
Neuromuscular Blocking ◽  
Morbidly Obese ◽  
Laparoscopic Bariatric Surgery ◽  
Obese Patients ◽  
Randomized Clinical Study ◽  
Primary Element ◽  
Significant Difference ◽  
Residual Curarization ◽  
Surgery Department

Abstract Background Complete and rapid reversal of the effects of neuromuscular blocker drugs is a primary element of safety in anaesthesia. Neuromuscular conduction that is not completely improved leads to post-operative residual curarisation and the development of complications that are related to respiration. Aim of the Work to compare between the effect of neostigmine and sugammadex on the duration of the recovery from neuromuscular blocking agents and postoperative residual curarization and respiratory complications in the obese patients undergoing laparscopic surgery. Patients and Methods We carried out this randomized clinical study on sixty four patients operated upon at General Surgery Department at Armed Forces Hospitals. Patients and Methods: In this study, 64 patients of either sex with average age ranging from 18-65 years, ASA (I,II), submitted for bariatric gastric sleeve operation were included in this study. Patients were randomly classified into 2 equal groups; Group S (sugammadex, n = 32) and group N (neostigmine, n = 32). Results: no significant differences between both groups regarding age, gender, BMI and ASA. But, we showed statistically a high significant difference between both groups regarding TOF0.9 and significant differences between both groups regarding PACU and operative room time. Conclusion This study verified the efficiency of sugammadex over neostigmine for full and timely reversal of neuromuscular blockade induced by a rocuronium, in morbidly obese patients undergoing laparoscopic bariatric surgery.

scholarly journals Outcome of Anticoagulant Therapy Following Bariatric Surgery

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M Yousef ◽  
A F Mohamed ◽  
B H Elshayeb ◽  
G M Abdelmalak
Keyword(s):  
Bariatric Surgery ◽  
Effective Means ◽  
Cost Benefit ◽  
Morbidly Obese ◽  
Laparoscopic Bariatric Surgery ◽  
Obese Patients ◽  
University Hospitals ◽  
Coagulation Therapy ◽  
Anticoagulant Drugs ◽  
Significant Difference

Abstract Background Bariatric surgery remains the most effective means of treating severe obesity. The number of severely obese patients is increasing and, consequently, more people are seeking bariatric surgery. Aim of the Work The Aim of This Study is to Outcome of Anticoagulant during Bariatric Surgery and Relation of Bariatric Surgery to Coagulopathy Disease. Patients and Methods This prospective study was conducted on 50 morbidly obese patients admitted to Hospital (Ahmed Maher Teaching Hospital and Ain Shams University Hospitals), for a primary one-stage laparoscopic bariatric surgery procedure over a 6-month period. The study is performed on 50 Patients, Who met all Inclusion criteria and none of Exclusion criteria. Results The study revealed no statistically significant difference between Enoxaparin and Rivaroxaban according to outcome of anti-coagulation therapy following bariatric surgery. Conclusion a high protective value of Chemical Thromboprophylaxis combined to Mechanical Thromboprophylaxis in preventing DVT safely. New Oral Anticoagulant drugs showed equal and may be superimposed the other traditional anticoagulant, but it needs more studies regarding its prophylactic dose, number of patient and its cost benefit in comparison with other Anticoagulant drugs were used in our study or other studies we mentioned above.

scholarly journals Biodistribution of the radiopharmaceutical sodium pertechnetate after biliopancreatic bypass with a duodenal switch

2007 ◽  
Vol 50 (spe) ◽  
pp. 189-197 ◽  
Author(s):  
Irami Araújo-Filho ◽  
Amália Cínthia Meneses Rêgo ◽  
José Brandão-Neto ◽  
Arthur Villarim-Neto ◽  
Eryvaldo Sócrates Tabosa Egito ◽  
...  
Keyword(s):  
Small Bowel ◽  
Biliopancreatic Diversion ◽  
Duodenal Switch ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Late Mortality ◽  
Biliopancreatic Bypass ◽  
Sodium Pertechnetate ◽  
Significant Difference

Study with the purpose to examine the effects of duodenal switch (DS), regularly performed in morbidly obese patients, on biodistribution of sodium pertechnetate in several organs of rats. There was no early or late mortality in either rats groups. The values of percent radioactivity per gram of tissue (%ATI/g), showed no significant difference in liver, stomach, small bowel, duodenum, kidney, heart, bladder, bone and brain, when compared the DS rats with sham and controls rats. A postoperative significant increase (p<0.05) in mean %ATI/g levels was observed in spleen, pancreas and muscle in group DS rats, as compared to group S and C rats. In the lung there was an increase and in thyroid a decrease in mean %ATI/g of DS rats, when compared to sham rats (p<0.05). In conclusion, the biliopancreatic diversion with duodenal switch in rats modified the biodistribution of sodium pertechnetate in thyroid, lung, pancreas, spleen and muscle.

Anaesthesia for the obese patient

2017 ◽  
Author(s):  
Frédérique S. Servin ◽  
Valérie Billard
Keyword(s):  
Body Mass ◽  
Elective Surgery ◽  
Rapid Sequence Induction ◽  
Total Body Weight ◽  
Blocking Agent ◽  
Anaesthetic Management ◽  
Neuromuscular Blocking ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Increased Risk

Obesity is becoming an epidemic health problem, and the number of surgical patients with a body mass index of more than 50 kg m−2 requiring anaesthesia is increasing. Obesity is associated with physiopathological changes such as metabolic syndrome, cardiovascular disorders, or sleep apnoea syndrome, most of which improve with weight loss. Regarding pharmacokinetics, volumes of distribution are increased for both lipophilic and hydrophilic drugs. Consequently, doses should be adjusted to total body weight (propofol for maintenance, succinylcholine, vancomycin), or lean body mass (remifentanil, non-depolarizing neuromuscular blocking agent). For all drugs, titration based on monitoring of effects is recommended. To minimize recovery delays, drugs with a rapid offset of action such as remifentanil and desflurane are preferable. Poor tolerance to apnoea with early hypoxaemia and atelectasis warrant rapid sequence induction and protective ventilation. Careful positioning will prevent pressure injuries and minimize rhabdomyolysis which are frequent. Because of an increased risk of pulmonary embolism, multimodal prevention is mandatory. Regional anaesthesia, albeit technically difficult, is beneficial in obese patients to treat postoperative pain and improve rehabilitation. Maximizing the safety of anaesthesia for morbidly obese patients requires a good knowledge of the physiopathology of obesity and great attention to detail in planning and executing anaesthetic management. Even in elective surgery, many cases can be technical challenges and only a step-by-step approach to the avoidance of potential adverse events will result in the optimal outcome.

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