title: Anesthetic management of morbidly obese and super-morbidly obese patients undergoing bariatric operations: hospital course and outcomes.
abstract: BACKGROUND
  Although the implications for the anesthetic and perioperative care of severely obese patients undergoing weight loss operations are considerable, current anesthetic management of super-obese (SO) patients (BMI > or =50 kg/m(2)), including super-super-obese (BMI > or =60) derives from experience with morbidly obese (MO) patients (BMI 40-49.9 kg/m(2)). We compared anesthetic and perioperative data of SO patients and MO patients undergoing weight loss operations to evaluate if anesthetic management influenced outcome.
  
  
  METHODS
  A retrospective analysis was performed on data from 150 consecutive patients (119 MO, 31 SO) undergoing bariatric surgery between May 2000 and March 2005. Data analyzed included preoperative anesthetic assessment, anesthetic management, postoperative care, and intra- or postoperative complications.
  
  
  RESULTS
  There were no differences in anesthetic management or in postoperative course or outcome between MO and SO patients. Intraoperative surgical complications occurred in 26% (n=8) in the SO group and 14% (n=15) in the MO group (P<0.01).
  
  
  CONCLUSIONS
  No differences in outcome occurred between MO and SO patients undergoing bariatric operations under similar anesthetic management. Anesthesia for weight loss surgery can be safely performed on SO patients with the understanding that these patients are not at risk per se due to their higher BMI. The degree of obesity influenced only the incidence of intraoperative surgical complications.
authors.affiliation: Department of Anesthesia, Pain, Perioperative Medicine and Intensive Care, Santa Maria degli Angeli Hospital, Pordenone, Italy. Yigal.Leykin@aopn.fvg.it
authors.forename: Yigal
authors.initials: Y
authors.lastname: Leykin
authors.forename: Tommaso
authors.initials: T
authors.lastname: Pellis
authors.forename: Eric
authors.initials: E
authors.lastname: Del Mestro
authors.forename: Bernardo
authors.initials: B
authors.lastname: Marzano
authors.forename: Giovanni
authors.initials: G
authors.lastname: Fanti
authors.forename: Jay B
authors.initials: JB
authors.lastname: Brodsky
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000009:adverse effects* / Q000379:methods*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D008297:Male; D009767:Obesity, Morbid / Q000503:physiopathology* / Q000601:surgery*; D019990:Perioperative Care / Q000592:standards; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome