Anaesthesia and intensive care for patients with morbid obesity

ABSTRACT

Fifty major surgical procedures were carried out on 48 morbidly obese patients in king Fahd Hospital -Jeddah and Jubail Hospital, Eastern Province, from year 1407 to year 1414. There were 44 females and 4 males. The age range was 14-52 Years [mean 31.8, S.D. 8.08]. The weights ranged from 97-183 kg [mean 126.97 kg, S.D 17.86]. All patients received general anaesthesia and they were all admitted to the Intensive Care Unit after operation. Fourteen patients needed prolonged endotracheal intubation with assisted ventilation after operation for an average of 9.7 hours. While the average stay in I. C. U. was 39.5 hours. No special anaesthesia tevhnique was recommended, the only emphasis was on careful monitoring during anaesthesia of all the vital signs, the arterial blood gases and acid base balance and on the necessity of having a central venous line and arterial line. In the I. C. U., hypoxaemnia occurred in 14 patients [simple in 9, severe and recurrent in 5]. Other metabolic changes included hyperglycaemia in [35 cases], hypocalcaemia [13 cases], elevation of the liver enzymes in [32 cases] and acidosis in [4 cases] We recommend post-operative extubation as early as possible and we reserve I. C. U. beds only for patients who have additional medical problems