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Title:Posebnosti anestezije pri morbidno debelem bolniku z rakom : prikaz primera
Authors:ID Potočnik, Iztok (Author)
ID Nizič, Tea (Author)
ID Stražišar, Branka (Author)
Files:.pdf PDF - Presentation file, download (173,51 KB)
MD5: 92AA7F7E3CBDEFEB45B6690E361B4799
 
Language:Slovenian
Typology:1.02 - Review Article
Organization:Logo OI - Institute of Oncology
Abstract:Debelost je kronična bolezen, za katero je značilno čezmerno kopičenje maščevja v telesu. Debeli bolniki imajo pogosto številne pridružene bolezni ter anatomske in presnovne spremembe, ki so povezane z večjim tveganjem za zaplete v perioperativnem obdobju. Debelost tako pomembno vpliva na izbiro anestezijske tehnike in zahteva multidisciplinarni pristop. V prispevku predstavljamo primer 60-letne bolnice z rakom na debelem črevesu in indeksom telesne mase (ITM) 48,1 kg/m2. Perioperativno smo jo obravnavali v skladu s protokolom za hitro okrevanje po kirurškem posegu (angl. Enhanced Recovery After Surgery, ERAS). Pred kirurškim posegom smo ocenili morebitna tveganja in jih upoštevali pri vodenju anestezije med kirurškim posegom. Po posegu smo bolnico obravnavali v enoti intenzivne terapije (EIT). V prispevku se osredotočamo na anesteziološke vidike perioperativnega vodenja. Čeprav je debelost nedvomno pomemben dejavnik tveganja kirurškega zdravljenja, pa v novejših raziskavah poročajo tudi o ugodnih vplivih debelosti z manjšo perioperativno obolevnostjo in smrtnostjo. Gre za t. i. paradoks debelosti, saj čezmerna telesna masa velja za zaščitni dejavnik, ki varuje pred zapleti kirurškega zdravljenja, kar smo potrdili tudi v našem primeru. Hkrati smo opredelili kritične točke pri anesteziji morbidno debelega bolnika in tista področja, na katerih lahko anesteziologi – ob upoštevanju protokola ERAS – pomembno prispevamo k bolnikovemu čim hitrejšemu okrevanju
Keywords:debelost, indeks telesne mase, kirurgija
Publication status:Published
Publication version:Version of Record
Publication date:01.06.2023
Place of publishing:Ljubljana
Publisher:Onkolološki inštitut
Year of publishing:2023
Number of pages:str. 24-29
Numbering:Leto 27, št. 1
Source:Ljubljana
PID:20.500.12556/DiRROS-16748 New window
UDC:616-089
ISSN on article:1408-1741
DOI:10.25670/oi2023-004on New window
COBISS.SI-ID:159199747 New window
Copyright:by Authors
Publication date in DiRROS:27.07.2023
Views:686
Downloads:174
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Record is a part of a journal

Title:Onkologija
Shortened title:Onkologija
Publisher:Onkološki inštitut
ISSN:1408-1741
COBISS.SI-ID:65324032 New window

Licences

License:CC BY 4.0, Creative Commons Attribution 4.0 International
Link:http://creativecommons.org/licenses/by/4.0/
Description:This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.
Licensing start date:01.06.2023

Secondary language

Language:English
Title:Peculiarities of anesthesia in the morbidly obese cancer patient : a case report
Abstract:Obesity is a chronic disease characterized by an excessive accumulation of body fat. Obese patients often have a number of comorbidities as well as anatomical and metabolic changes that increase the risk of complications in the perioperative period of treatment and significantly influence the choice of anesthetic technique as well as requiring a multidisciplinary approach. In this article, we present the case of a 60-year-old female patient with colon cancer and a body mass index (BMI) of 48.1 kg/m2. She was treated perioperatively in accordance with the Enhanced Recovery After Surgery (ERAS) protocol. Before surgery, we assessed possible risks and took them into account when managing anesthesia during surgery. After surgery, the patient was treated in the intensive care unit (ICU). In this paper, we focus on the anesthesiology aspects of perioperative management. Although obesity is undoubtedly an important risk factor for surgical treatment, recent studies report favorable effects of obesity with lower perioperative morbidity and mortality. This is the so-called obesity paradox, as excessive body mass is considered a protective factor that protects against complications of surgical treatment, which we also confirmed in our case. At the same time, we defined the critical points in the anesthesia of a morbidly obese patient and identified those areas in which anesthesiologists — taking into account the ERAS protocol — can make a significant contribution to the patient recovering as quickly as possible.
Keywords:obesity, body mass index, surgery


Collection

This document is a part of these collections:
  1. Onkologija : strokovni časopis za zdravnike

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