Positioning and Anesthesia Challenges In a Morbidly Obese Patient Undergoing Cervical Spine Surgery

Authors

  • Keyuri Popat Associate Professor, Department of Anesthesiology and Perioperative Medicine, The Univer- sity of Texas MD Anderson Cancer Center, Houston, Texas, USA
  • David Z. Ferson Professor, Department of Anesthesiology and Perioperative Medicine, The University of Tex- as MD Anderson Cancer Center, Houston, Texas, USA
  • Brian Galle Nurse Anesthetist, Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  • Roxana Grasu Associate Professor, Department of Anesthesiology and Perioperative Medicine, The Univer- sity of Texas MD Anderson Cancer Center, Houston, Texas, USA
  • Gisela Sanchez Advanced Practice Nurse, Department of Neurosurgery, The University of Texas MD Ander- son Cancer Center, Houston, Texas, USA
  • Claudio Tatsui Assistant Professor, Department of Neurosurgery, The University of Texas MD Anderson Can- cer Center, Houston, Texas, USA
  • Lawrence Rhines Professor, Department of Neurosurgery, The University of Texas MD Anderson Cancer Cen- ter, Houston, Texas, USA

DOI:

https://doi.org/10.17140/RPAOJ-1-104

Abstract

Background Context: By itself, the perioperative anesthesia management of morbidly obese patients is challenging; this task is further complicated when such patients have to be placed in the prone position for surgery. In these cases, challenges may include positioning, intubation and ventilation.
Purpose: Herein, we describe the safe perioperative anesthesia care of a morbidly obese patient undergoing cervical spine surgery for an enlarging schwannoma.
Study Setting: Morbidly obese patient care at a tertiary cancer institute.
Patient Sample: Single case report.
Methods: Describing the preparation and planning for this complex case and the perioperative care of a patient with several comorbidities. No conflict of interest to report for any of the authors.
Results: Good patient outcome.
Conclusion: Careful multi-disciplinary planning facilitates, good patient outcome, given the challenging nature of the case. Highlighting the use of a trial run in the operating prior to the day of surgery.

References

Kalanithi PA, Arrigo R, Boakye M. Morbid obesity increases cost and complication rates in spinal arthrodesis. Spine. 2012; 37(11): 982-988. doi: 10.1097/BRS.0b013e31823bbeef

Bellamy MC, Margarson MP. Designing intelligent anesthe-sia for a changing patient demographic: a consensus statement to provide guidance for specialist and non-specialist anesthetists written by members of and endorsed by the Society for Obesity and Bariatric Anaesthesia (SOBA). Perioper Med. 2013; 2(1): 12. doi: 10.1186/2047-0525-2-12

Harbut P, Gozdzik W, Stjernfalt E, Marsk R, Hesselvik JF. Continuous positive airway pressure/pressure support pre-oxy-genation of morbidly obese patients. Acta Anaesthesiol Scand. 2014; 58(6): 675-680. doi: 10.1111/aas.12317

Gaszynski T. [Pre-oxygenation in morbidly obese patients]. Anestezjol Intens Ter. 2010; 42(3): 133-136. Web site. http://eu-ropepmc.org/abstract/med/21413417. Accessed December 29, 2015.

Strandberg A, Tokics L, Brismar B, Lundquist H, Hedensti-erna G. Constitutional factors promoting development of atelec-tasis during anaesthesia. Acta Anaesthesiol Scand. 1987; 31(1): 21-24. doi: 10.1111/j.1399-6576.1987.tb02513.x

Bardoczky GI, Yernault JC, Houben JJ, d’Hollander AA. Large tidal volume ventilation does not improve oxygenation in morbidly obese patients during anesthesia. Anesth Analg. 1995; 81(2): 385-388. Web site. http://journals.lww.com/anesthesia-analgesia/Abstract/1995/08000/Large_Tidal_Volume_Venti-lation_Does_Not_Improve.30.aspx. Accessed December 29, 2015.

Reinius H, Jonsson L, Gustafsson S, et al. Prevention of atel-ectasis in morbidly obese patients during general anesthesia and paralysis: a computerized tomography study. Anesthesiology. 2009; 111(5): 979-987. doi: 10.1097/ALN.0b013e3181b87edb

Messerole E, Peine P, Witt kopp S, Marini JJ, Albert RK. The Pragmatics of prone positioning. Am J Respir Crit Care Med. 2002; 165(10): 1359-1363. doi: 10.1164/rccm.2107005

Downloads

Published

2016-04-29

How to Cite

Keyuri Popat, David Z. Ferson, Brian Galle, Roxana Grasu, Gisela Sanchez, Claudio Tatsui, & Lawrence Rhines. (2016). Positioning and Anesthesia Challenges In a Morbidly Obese Patient Undergoing Cervical Spine Surgery. Research and Practice in Anesthesiology, 1(1), 15–18. https://doi.org/10.17140/RPAOJ-1-104

Issue

Vol. 1 No. 1 (2016): Volume 1 Issue 1 2016

Section

Articles

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

All content published in Research and Practice in Anesthesiology (RPA) is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows anyone to copy, distribute, transmit, and adapt the work — including for commercial purposes — provided appropriate credit is given to the original author(s) and source.