Anästhesiologische Besonderheiten bei morbider Adipositas

Zusammenfassung

Die Anästhesie bei Patienten, die sich einem bariatrischen Eingriff unterziehen, stellt eine nicht zu unterschätzende Herausforderung für den klinisch tätigen Anästhesisten dar. Es gilt die besondere Pathophysiologie adipöser Patienten, deren Begleiterkrankungen und die mit morbider Adipositas assoziierten Komplikationen genau zu kennen. Dies ermöglicht ein differenziertes Vorgehen in der perioperativen Betreuung, welches zusammen mit einer gesteigerten Aufmerksamkeit aller Beteiligten und einer adäquaten postoperativen Überwachung zu einer Reduktion des perioperativen Risikos für den Patienten führen kann. In dem folgenden Artikel sollen die anästhesiologisch relevanten Aspekte der Pathophysiologie bei Adipositas aufgezeigt werden, da durch ihre Kenntnis eine fundierte Einschätzung des perioperativen Risikos adipöser Patienten ermöglicht wird. Auf dieser Basis werden anästhesiologische Handlungskonzepte in der prä-, intra- und postoperativen Phase eines bariatrischen Eingriffs sowie Komplikationen und deren mögliche Lösung dargestellt.

Abstract

Anaesthesia of patients for bariatric surgery is a major challenge. It is essential to take into account the specific pathophysiology, comorbidities and related complications associated with obesity. An increased attention and an adequate monitoring during arousal from anaesthesia should be an integral part of the perioperative management. This article is designed to overview the anaesthesia-related pathophysiology of obesity. Based on this knowledge it is possible to estimate the perioperative risk situation for the obese patient. Furthermore, the following text presents concepts in performing anaesthesia for the pre-, peri- and postoperative phases and deals with some complications and their possible solutions.

Schlüsselwörter

Adipositaschirurgie - anästhesiologische Besonderheiten - Handlungskonzepte

Key words

bariatric surgery - anaesthesiological challenges - concepts of performing anaesthesia

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