Clinical Considerations and Outcomes of Robotic Urologic Surgery in Obese Patients.

Nazih Khater, Anna G Morris, Delena M Vanvalkenburg, Andrew J Garcia, Kevin Jin, Shahab Ahmadzadeh, Sahar Shekoohi, Elyse M Cornett, Alan David Kaye
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Abstract

Obesity is associated with many significant physiological changes. These considerations are important to surgery, especially in urological procedures. Obese patients often undergo surgical procedures and are at higher risk of complications. This investigation reviews physiological and anaesthesia considerations for obese and morbidly obese patients. In addition, urological surgeries and procedures should be considered for these higher risk patients. Clinical anaesthesiologists must use detailed assessment and, when appropriate, consultation in developing safe anaesthesia plans for these patients. Newer technologies have improved safety related to airway management, advanced airway devices, and regional anaesthesia with ultrasound-guided nerve blocks, which can reduce the need for opioids postoperatively. Recent developments in drug and monitoring technologies have also been developed and can be effective for obese and morbidly obese patients undergoing urological procedures and perioperative surgery, thus improving the likelihood of safety in this higher risk population.

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肥胖患者机器人泌尿外科手术的临床考虑因素和结果。
肥胖与许多重大的生理变化有关。这些因素对外科手术非常重要,尤其是泌尿外科手术。肥胖患者经常接受外科手术,出现并发症的风险较高。本研究回顾了肥胖和病态肥胖患者的生理和麻醉注意事项。此外,泌尿科手术和程序也应考虑到这些高风险患者。临床麻醉医师在为这些患者制定安全的麻醉计划时必须进行详细评估,并在适当时进行咨询。新技术提高了气道管理、先进气道设备和超声引导神经阻滞区域麻醉的安全性,从而减少了术后对阿片类药物的需求。药物和监测技术也有了最新发展,对接受泌尿科手术和围术期手术的肥胖和病态肥胖患者也很有效,从而提高了这类高风险人群的安全可能性。
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