The features of anesthesia in bariatric surgery


E.Y. Garbuzov, G.A. Ovsyannikov, S.G. Sherbak

City Hospital № 40, Saint-Petersburg

For correspondence: Evgenii Garbuzov — MD, head of Department of anesthesiology and intensive care of Saint-Petersburg clinical hospital № 40, Saint-Petersburg; e-mail:

For citation: Garbuzov EY, Ovsyannikov GA, Shcherbak SG. The features of anesthesia in bariatric surgery. Alexander Saltanov Intensive Care Herald. 2018;2:31–5.

DOI: 10.21320/1818-474X-2018-2-31-35

Nowadays obesity is a worldwide problem. Changes associated with the obesity commonly increase risks of perioperative complications that could be fatal. The increasing of fat tissue influences significantly on pharmacokinetic of intravenous drugs, nevertheless effects of inhaled anesthetics remain more predictable. Structural changes of upper airways, sleep apnea obstructive syndrome, cervical osteochondrosis reduce visualization in direct laryngoscopy. Frequency of difficult tracheal intubation in patients with body weight index more than 40 kg/m2 reaches 13–24 %. In some cases awake tracheal intubation is necessary, that changes a traditional induction plan. Morbid obesity patients have often cardiovascular diseases, respiratory system disorders and increased intra-abdominal pressure, therefore they need a differentiated approach for ventilation strategy for safe anesthesia. Knowledge of the pathophysiology of these changes allows to take measures to prevent serious complications. Nowadays in the general surgery department of the Saint-Petersburg City Hospital № 40 we perform two types of bariatric operations: sleeve — resection and gastric-bypass. In this article we have presented our experience of perioperative management of morbid obese patient for bariatric surgery.

Keywords: anesthesia, morbid obesity, bariatric surgery, laparoscopic surgery, difficult airways, inhaled anesthetics, monitoring of neuromuscular block

Received: 20.12.2017

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