Präoperative Evaluation und anästhesiologisches Management bei Adipositas

Zusammenfassung

Adipositas ist sowohl in medizinischer als auch in sozioökonomischer Hinsicht ein ständig wachsendes Problem der Industriestaaten. Der anästhesiologischen Versorgung adipöser Patienten kommt daher eine immer größere Rolle zu. Es ist notwendig, die besondere Pathophysiologie adipöser Patienten, deren Begleiterkrankungen und die mit morbider Adipositas assoziierten Komplikationen genau zu kennen. Eine fundierte präoperative Evaluation des perioperativen Risikos adipöser Patienten ermöglicht ein differenziertes Vorgehen in der perioperativen Betreuung, das zusammen mit einer gesteigerten Aufmerksamkeit aller Beteiligten und einer adäquaten postoperativen Überwachung zu einer Reduktion des perioperativen Risikos für den Patienten führen kann. Neben der Kenntnis physiologischer Besonderheiten sind pharmakologische Konsequenzen der Adipositas zu berücksichtigen. Apparative Ausstattung und logistische Voraussetzungen sowie entsprechende Erfahrungen des Anästhesieteams tragen zur Risikominimierung für diese Patientengruppe bei.

Summary

Obesity is a growing medical and social economical problem in the developed countries. Therefore, the anaesthesiological care of obese patients is becoming increasingly important. It is fundamental to acknowledge the specific pathophysiology of the obese, their concomitant diseases, and the complications associated with morbid obesity. A systematic assessment of the perioperative risk factors is essential for an appropriate perioperative management. In particular, increasing attentiveness of all involved physicians and adequate postoperative care are expected to reduce the perioperative risks in obese patients. Physiological and pharmacological characteristics of the obese should also be considered. Sufficient technical equipment and practical experience of the anaesthesiological team further contribute to therapeutic success in obese patients.

Schlüsselwörter

Adipositas - Anästhesie - Evaluierung

Keywords

Obesity - anaesthesia - evaluation

• Literatur

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