Effects of beach chair position and pneumoperitoneum on lung volume in obese patients undergoing laparoscopic gastric banding

2001 ◽  
Vol 18 (Supplement 21) ◽  
pp. 52
Author(s):  
F. Valenza ◽  
F. Vagginelli ◽  
M. Valsecchi ◽  
F. Fazzi ◽  
L. Gattinoni
Keyword(s):  
Gastric Banding ◽  
Lung Volume ◽  
Laparoscopic Gastric Banding ◽  
Obese Patients ◽  
Beach Chair Position ◽  
Beach Chair

scholarly journals Preemptive Alveolar Recruitment Maneuver Followed by PEEP in Obese Patients Undergoing Laparoscopic Gastric Banding. Does it make a Difference? A Randomized Controlled Clinical Study

2019 ◽  
Vol 13 (1) ◽  
pp. 31-39
Author(s):  
Sherif A. Elokda ◽  
Hanan M. Farag
Keyword(s):  
Gastric Banding ◽  
Lung Volume ◽  
Respiratory Mechanics ◽  
Recruitment Maneuver ◽  
Laparoscopic Gastric Banding ◽  
Alveolar Recruitment ◽  
Controlled Study ◽  
Obese Patients ◽  
Alveolar Recruitment Maneuver ◽  
Standard Ventilation

Background: Impaired respiratory functions during general anesthesia are commonly caused by lung atelectasis more in morbidly obese patients. This occurs more frequently with laparoscopic surgery due to trendelenburg position and pneumoperitoneum. Preemptive recruitment maneuver + PEEP results in the prevention of these changes. Aim: To quantitate the effects of RM and PEEP on intraoperative hypoxemia and respiratory mechanics during laparoscopic gastric banding in obese patients. Study Design: A randomized, double-blinded, controlled study. Method and Materials: Fifty adults ASA I-II, BMI (40-50 kg/m2) for elective laparoscopic gastric banding were randomized into, groups C, and RM, 25 patients each. Group C patients received standard ventilation, VT 6 ml/kg, I: E ratio 1: 2 PEEP 5 cm H2O, and respiratory rate 10-12 breaths/ min. RM patients received standard ventilation with one alveolar recruitment maneuver after mechanical ventilation with PEEP of 15 cm H2O till the end of the surgery. Heart rate, mean blood pressure, respiratory mechanical parameters: peak airway pressure, plateau pressure and end-expiratory lung volume, PaO2, PaO2/FiO2 and (SpO2) were assessed. Results: PaO2 and PaO2/FiO2 ratio increased significantly in the RM group after RM from T2 (before pneumoperitoneum) to T6 (end of surgery) compared with group C (P < 0.001). Peak and plateau airway pressures increased significantly in group C from T2 till T5 (60 min after pneumoperitoneum) compared with the RM group (P < 0.001). End-expiratory lung volume increased significantly in the RM group after RM compared with group C (P<0.001). Conclusion: Preemptive RM with PEEP of 15 cm H2O was effective in preventing pneumoperitoneum-induced intraoperative hypoxemia and respiratory mechanics changes.

scholarly journals Effects of the Beach Chair Position, Positive End-expiratory Pressure, and Pneumoperitoneum on Respiratory Function in Morbidly Obese Patients during Anesthesia and Paralysis

2007 ◽  
Vol 107 (5) ◽  
pp. 725-732 ◽  
Author(s):  
Franco Valenza ◽  
Federica Vagginelli ◽  
Alberto Tiby ◽  
Silvia Francesconi ◽  
Giulio Ronzoni ◽  
...  
Keyword(s):  
Lung Volume ◽  
Respiratory Function ◽  
Laparoscopic Gastric Banding ◽  
Arterial Oxygen Tension ◽  
Ideal Body Weight ◽  
Arterial Oxygen ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Positive End Expiratory Pressure ◽  
Beach Chair

Background The authors studied the effects of the beach chair (BC) position, 10 cm H2O positive end-expiratory pressure (PEEP), and pneumoperitoneum on respiratory function in morbidly obese patients undergoing laparoscopic gastric banding. Methods The authors studied 20 patients (body mass index 42 +/- 5 kg/m2) during the supine and BC positions, before and after pneumoperitoneum was instituted (13.6 +/- 1.2 mmHg). PEEP was applied during each combination of position and pneumoperitoneum. The authors measured elastance (E,rs) of the respiratory system, end-expiratory lung volume (helium technique), and arterial oxygen tension. Pressure-volume curves were also taken (occlusion technique). Patients were paralyzed during total intravenous anesthesia. Tidal volume (10.5 +/- 1 ml/kg ideal body weight) and respiratory rate (11 +/- 1 breaths/min) were kept constant throughout. Results In the supine position, respiratory function was abnormal: E,rs was 21.71 +/- 5.26 cm H2O/l, and end-expiratory lung volume was 0.46 +/- 0.1 l. Both the BC position and PEEP improved E,rs (P &lt; 0.01). End-expiratory lung volume almost doubled (0.83 +/- 0.3 and 0.85 +/- 0.3 l, BC and PEEP, respectively; P &lt; 0.01 vs. supine zero end-expiratory pressure), with no evidence of lung recruitment (0.04 +/- 0.1 l in the supine and 0.07 +/- 0.2 in the BC position). PEEP was associated with higher airway pressures than the BC position (22.1 +/- 2.01 vs. 13.8 +/- 1.8 cm H2O; P &lt; 0.01). Pneumoperitoneum further worsened E,rs (31.59 +/- 6.73; P &lt; 0.01) and end-expiratory lung volume (0.35 +/- 0.1 l; P &lt; 0.01). Changes of lung volume correlated with changes of oxygenation (linear regression, R2 = 0.524, P &lt; 0.001) so that during pneumoperitoneum, only the combination of the BC position and PEEP improved oxygenation. Conclusions The BC position and PEEP counteracted the major derangements of respiratory function produced by anesthesia and paralysis. During pneumoperitoneum, only the combination of the two maneuvers improved oxygenation.

Room G, 10/16/2000 9: 00 AM - 11: 00 AM (PS) Hemodynamic and Respiratory Changes in Morbidly Obese Patients Undergoing Laparoscopic Gastric Banding

2000 ◽  
Vol 93 (Supplement) ◽  
pp. A-1109
Author(s):  
Katrin Bangert ◽  
Thomas Standl ◽  
Stephan H. Bohm ◽  
Marc Burmeister ◽  
Jochen Schulte Esch
Keyword(s):  
Gastric Banding ◽  
Laparoscopic Gastric Banding ◽  
Morbidly Obese ◽  
Obese Patients

Long-term cardiovascular risk and coronary events in morbidly obese patients treated with laparoscopic gastric banding

2014 ◽  
Vol 10 (1) ◽  
pp. 112-120 ◽  
Author(s):  
Luca Busetto ◽  
Fabio De Stefano ◽  
Sabrina Pigozzo ◽  
Gianni Segato ◽  
Maurizio De Luca ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Gastric Banding ◽  
Laparoscopic Gastric Banding ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Coronary Events

scholarly journals Comparison of Volume-controlled and Pressure-controlled Ventilation during Laparoscopic Gastric Banding in Morbidly Obese Patients

2008 ◽  
Vol 18 (6) ◽  
pp. 680-685 ◽  
Author(s):  
L. E. C. De Baerdemaeker ◽  
C. Van der Herten ◽  
J. M. Gillardin ◽  
P. Pattyn ◽  
E. P. Mortier ◽  
...  
Keyword(s):  
Gastric Banding ◽  
Laparoscopic Gastric Banding ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Controlled Ventilation ◽  
Pressure Controlled Ventilation ◽  
Volume Controlled ◽  
Pressure Controlled

scholarly journals Changes in Gallbladder Motility and Gallstone Formation Following Laparoscopic Gastric Banding for Morbid Obesity

2003 ◽  
Vol 17 (3) ◽  
pp. 169-174 ◽  
Author(s):  
Bilal O Al-Jiffry ◽  
Eldon A Shaffer ◽  
Gino TP Saccone ◽  
Peter Downey ◽  
Lilian Kow ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Weight Loss ◽  
Gastric Banding ◽  
Laparoscopic Gastric Banding ◽  
Gallstone Formation ◽  
Gallbladder Motility ◽  
Gallbladder Emptying ◽  
Rapid Weight Loss ◽  
Obese Patients ◽  
Residual Volume

Morbid obesity is associated with cholesterol gallstone formation, a risk compounded by rapid weight loss. Laparoscopic gastric banding allows for a measured rate of weight loss, but the subsequent risk for developing gallstones is unknown.METHOD: Twenty-six normal-weight volunteers (body mass index [BMI] less than 30) were compared with 14 morbidly obese patients (BMI greater than 40). Gallbladder volumes were measured ultrasonographically, after fasting and following stimulation with intravenous cholecystokinin-octapeptide (CCK-8).RESULTS: Preoperatively, fasting gallbladder volume and residual volume after CCK stimulation were both two times greater in the obese group (P<0.02 versus controls). Per cent gallbladder emptying was not different. Gallbladder refilling was four times higher in the obese patients (P<0.01). By six weeks postoperatively, the obese patients lost 1.4±0.1% body weight per week. Gallbladder emptying decreased 18.4% (80.3±3.9% to 65.5±6.9%; P<0.05); residual volume rose one-third (not significant), and refilling fell 60.5% (0.43±0.09 to 0.26±0.04 mL/min; P=0.07). Three patients with weight losses of greater than 1.7% per week developed gallstones; gallbladder emptying fell outside the 95 percentile. By six months, weight loss slowed to 0.5±0.1% per week; gallbladder motility improved modestly. No further stones developed.CONCLUSION: Rapid weight loss following laparoscopic gastric banding impairs gallbladder emptying and when pronounced, gallstones form by six weeks postoperatively. The accompanying reduction in gallbladder emptying, increased gallbladder residual volume and decreased refilling promote gallbladder stasis and hence stone formation.

Plasma Protein Carbonyl and Thiol Stress Before and After Laparoscopic Gastric Banding in Morbidly Obese Patients

2007 ◽  
Vol 17 (10) ◽  
pp. 1367-1373 ◽  
Author(s):  
Hafize Uzun ◽  
Dildar Konukoglu ◽  
Remisa Gelisgen ◽  
Kagan Zengin ◽  
Mustafa Taskin
Keyword(s):  
Gastric Banding ◽  
Plasma Protein ◽  
Laparoscopic Gastric Banding ◽  
Protein Carbonyl ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Before And After

scholarly journals Hemodynamic and Hormonal Stress Responses to Endotracheal Tube and ProSeal Laryngeal Mask AirwayTMfor Laparoscopic Gastric Banding

2012 ◽  
Vol 117 (2) ◽  
pp. 309-320 ◽  
Author(s):  
Michele Carron ◽  
Stefano Veronese ◽  
Walter Gomiero ◽  
Mirto Foletto ◽  
Donato Nitti ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Laryngeal Mask Airway ◽  
Gastric Banding ◽  
Endotracheal Tube ◽  
Stress Responses ◽  
Laparoscopic Gastric Banding ◽  
Laryngeal Mask ◽  
Postanesthesia Care Unit ◽  
Plasma Norepinephrine ◽  
Obese Patients

Background The stress responses from tracheal intubation are potentially dangerous in patients with higher cardiovascular risk, such as obese patients. The primary outcome objective of this study was to test whether, in comparison with the endotracheal tube (ETT), the Proseal™ Laryngeal Mask Airway (PLMA™) (Laryngeal Mask Airway Company, Jersey, United Kingdom) reduces blood pressure and norepinephrine responses and the amounts of muscle relaxants needed in obese patients. Methods We assessed hemodynamic and hormonal stress responses, ventilation, and postoperative recovery in 75 morbidly obese patients randomized to receive standardized anesthesia with either an ETT or the PLMA™ for laparoscopic gastric banding. Results In repeated-measures ANOVA, mean arterial blood pressure and plasma norepinephrine were significantly higher in the ETT group than in the PLMA™ group. In individual pairwise comparisons, blood pressure rose higher in ETT than PLMA™ patients after insertion and removal of airway devices, and after recovery. In ETT compared with PLMA™ patients, plasma norepinephrine was higher after induction of carboperitoneum (mean ± SD, 534 ± 198 and 368 ± 147 and pg/ml, P = 0.001), after airway device removal (578 ± 285 and 329 ± 128 pg/ml, P &lt; 0.0001), and after recovery in postanesthesia care unit (380 ± 167 and 262 ± 95 and pg/ml, P = 0.003). Compared with use of the ETT, the PLMA™ reduced cisatracurium requirement, oxygen desaturation, and time to discharge from both the postanesthesia care unit and the hospital. Conclusions PLMA™ reduces stress responses and postoperative complaints after laparoscopic gastric banding.

Sign in / Sign up

Export Citation Format

Share Document