Anesthesia with sevoflurane in bariatric surgery.
BACKGROUND
Sevoflurane is a good halogen agent for bariatric surgery anesthesia because of its physical and chemical characteristics and its repartition coefficient (blood/gas = 0.65).


METHODS
From November 1997 to April 1998, 98 bariatric surgery procedures with sevoflurane anesthesia were done: 17 lipectomies, 71 vertical gastroplasties, and 10 biliopancreatic diversions in 71 women and 27 men, average age 30.3+/-8.3 years, with body mass index 43.9+/-5.7. The average operating time was 50+/-15 minutes for vertical gastroplasty, 160+/-20 minutes for biliopancreatic diversion, and 80+/-12 minutes for lipectomy. The technique of anesthesia was as follows: preanesthesia with atropine sulfate 0.01 mg/kg (dosage refers to ideal weight), ranitidine 50 mg, fentanyl 0.1 mg, ketorolac 60 mg; induction with propofol 0.5-1 mg/kg, succinylcholine 1 mg/kg; orotracheal intubation; maintenance with O2-N2O 50%, sevoflurane 1% to 1.5%, actracurium 0.5 mg/kg (dosage refers to ideal weight); awakening and decurarization with atropine sulfate 1 mg and prostigmine 2 mg.


RESULTS
This method permitted correct control of the anesthesia, a quick awakening with a low incidence of nausea and vomiting, a prompt regain of physical and psychological functioning, an early discharge from the hospital, and a larger turnover of patients with lower costs.


CONCLUSIONS
Sevoflurane balanced anesthesia seems to be the best anesthesiologic method for bariatric surgery.
Martinotti
R
R
Ospedale Civile di Stradella, ASL Pavia, Italy.
Vassallo
C
C
Ramaioli
F
F
De Amici
D
D
Della Marta
M E
ME
D000328:Adult; D000768:Anesthesia, General / Q000379:methods*; D018685:Anesthetics, Inhalation; D015904:Biliopancreatic Diversion / Q000379:methods; D005260:Female; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D015187:Lipectomy / Q000379:methods; D008297:Male; D008738:Methyl Ethers; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012680:Sensitivity and Specificity; D000077149:Sevoflurane; D016896:Treatment Outcome
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane