Chapter

Recovery and post-operative care

Mark Bellamy and Michel Struys

in Anaesthesia for the Overweight and Obese Patient

Published on behalf of Oxford University Press

ISBN: 9780199233953
Published online May 2011 | e-ISBN: 9780199607051 | DOI: http://dx.doi.org/10.1093/med/9780199233953.003.0010

Series: Oxford Anaesthesia Library

Recovery and post-operative care

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• Emergence from anaesthesia carries significant risks for the morbidly obese. • There is a significant risk of hypoxia and loss of control of the airway during the transition from stable anaesthesia to the awake state. • The anaesthetic technique deployed should be consistent with rapid emergence from anaesthesia and good early airway control. • Measures of early recovery suggest more rapid emergence from anaesthesia in desflurane-treated patients, but differences have largely disappeared by the time the patient leaves the recovery room. • A multimodality approach to post-operative analgesia affords good pain relief with least risk of drug side-effects. • Post-operative intravenous opioids can result in poor post-operative respiratory function. • Regional anaesthetic techniques can be used for post-operative pain – success can be improved by the use of ultrasound. • Thoracic epidural anaesthesia is associated with better preservation of respiratory function in the obese as compared with post-operative opiate analgesia. • Post-operatively, morbidly obese patients should be nursed an appropriate environment. • If no appropriate post-operative care facility is available, elective surgery should not proceed.

Chapter.  3206 words.  Illustrated.

Subjects: Anaesthetics

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