Role of Intraoperative Beta Blocker for Morbid Obese Patients Undergoing Laparoscopic Bariatric Surgery

Abstract Background: Venous thromboembolism (VTE) is a serious complication that may occur after bariatric surgery. This study aims to report the rate of clinically evident VTE using pharmacologic versus non-pharmacologic prophylaxis among morbid obese patients undergoing laparoscopic bariatric surgery who were at low risk for VTE.Methods: The laparoscopic research center database from 2017 to 2018 was queried to identify patients undergoing laparoscopic bariatric surgery. Retrospectively, each patient who met the inclusion and exclusion criteria was clinically evaluated for the presence of symptomatic VTE (DVT and PTE) during the postoperative period. VTE prophylaxis regimens were pharmacological prophylaxis or non-pharmacological prophylaxis. Results: We identified 794 patients who underwent bariatric surgery.110 patients excluded from the study based on the VTE risk factor. 371 (54.4%) patients had non-pharmacological, 313 (45.9%) patients had pharmacological prophylaxis. In the non-pharmacological group, the overall rates of DVT, and PTE were 1 (0.26%) and 1 (0.26%), respectively. In the pharmacological group, the overall rates of PTE and DVT were 2 (0.63%) and 0, respectively. Patients without pharmacological prophylaxis had no significant difference in DVT and PTE rate compared to the group which received pharmacological prophylaxis (P>0.5). Conclusions: Adequate VTE prophylaxis is achieved without pharmacological thromboprophylactic agents for lower-risk patients. Thus, an individualized prophylaxis regimen that balances efficacy and safety is suggested for each patient, based on various risk factors.

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Effect of perioperative dexmedetomidine infusion on blood glucose levels in non-diabetic morbid obese patients undergoing laparoscopic bariatric surgery

Egyptian Journal of Anaesthesia ◽

10.1016/j.egja.2018.05.004 ◽

2018 ◽

Vol 34 (3) ◽

pp. 75-81 ◽

Cited By ~ 1

Author(s):

Raham Hasan Mostafa ◽

Ibrahim Mohamed Ibrahim ◽

Ahmed H. Ayoub

Keyword(s):

Bariatric Surgery ◽

Blood Glucose ◽

Laparoscopic Bariatric Surgery ◽

Obese Patients ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Morbid Obese ◽

Dexmedetomidine Infusion

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The Influences of three Intraoperative Ventilatory Strategies on Arterial Oxygenation in Morbid Obese Patients Undergoing Laparoscopic Bariatric Surgery

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i1630995 ◽

2021 ◽

pp. 1-16

Author(s):

Shaimaa E. Shaban ◽

Reda S. Salama ◽

Mohamed M. Abu Elyazed ◽

Abdelraheem M. Dowidar

Keyword(s):

Bariatric Surgery ◽

Cardiac Output ◽

Respiratory Mechanics ◽

Recruitment Maneuver ◽

Conventional Ventilation ◽

Laparoscopic Bariatric Surgery ◽

Obese Patients ◽

Arterial Oxygenation ◽

Morbid Obese ◽

The Mean

Background: Maintaining satisfactory ventilation for obese patients undergoing bariatric surgery frequently poses a challenge for anesthetists. The optimal ventilation strategy during pneumoperitoneum remains obscure in obese patients. In this study, we investigated the effect of conventional ventilation, inverse ratio ventilation (IRV) and alveolar recruitment maneuver (RM) on arterial oxygenation, lung mechanics and hemodynamics in morbid obese patients undergoing laparoscopic bariatric surgery. Methods: 105 adult obese patients scheduled for elective laparoscopic bariatric surgery were randomly allocated into three groups: Conventional ratio ventilation (I:E ratio was 1:2, PEEP 5 cmH2O and no RM), Inverse Ratio Group (IRVG) (I:E ratio was 2:1 and PEEP 5 cmH2O and No RM ) and Recruitment Maneuver Group (RMG) ( RM was done and I:E ratio was 1:2). Arterial blood gases and respiratory mechanics were recorded after induction of anesthesia (T1), 5 minutes (T2), 30 minutes (T3), 60 minutes (T4) after the beginning of pneumoperitoneum and at the end of the surgery (T5). Cardiac output was recorded at (T1), (T2), (T3) and (T5). Results: At T3, T4 and T5, arterial oxygen tension was higher in RMG than IRVG than CG (P ˂ 0.05). At T3, T4 and T5, the mean airway pressure and dynamic compliance (Cdyn) were significantly higher in IRVG and RMG compared with CG (P ˂ 0.05) while at those times, the mean air way pressure and Cdyn in IRVG and RMG were comparable. Cardiac output result were comparable between all groups throughout the study period (P ˃ 0.05). Conclusions: RM and IRV had provided better arterial oxygenation and respiratory mechanics compared to conventional ventilation in morbid obese patients undergoing laparoscopic bariatric surgery. However, RM had better gas exchange than IRV.

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