ANESTHESIA FOR MORBIDLY OBESE PATIENTS

Bariatric surgery is the most effective method for treating patients w ith morbid obesity, and participation of the anesthesiologist in the t reatment of these patients is more and more frequent, Therefore it is important for anesthesiologists to be familiar with anatomic and physi ologic implications and the pharmacologic changes associated with obes ity, so they can offer optimal perioperative treatment. The present st udy describes a series of 37 patients with an average body mass index of 50.3 kg/m(2) who underwent bariatric surgery in a third-level teach ing hospital in Mexico City. Preoperative assessment, airway managemen t, perioperative treatment, and the incidence of complications are ana lyzed. We found a high frequency of associated diseases, among which d iabetes mellitus and systemic arterial hypertension were the most prom inent. Cardiorespiratory complications such as obstructive sleep apnea syndrome and obesity-hypoventilation syndrome were particularly frequ ent (16.2% and 22.0%, respectively), Both general anesthesia and mixed anesthesia (peridural block plus light general anesthesia) were emplo yed, The incidence of complications related to perioperative and anest hetic management was low. We discuss and propose protocols for the eva luation and management of airway and associated cardiorespiratory comp lications.