Document Detail


Anesthesia for a 228-kg patient (body mass index, 90.6) undergoing laparoscopic sleeve gastrectomy.
MedLine Citation:
PMID:  21340653     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
We undertook anesthesia of a 40-year-old woman with body weight of 228 kg and body mass index (BMI) of 90.6 kg/m(2) who was undergoing laparoscopic sleeve gastrectomy. This case may be the largest known patient undergoing general anesthesia in our country. Anesthesia was induced in a 30° head-up position with midazolam, fentanyl, droperidol, and inhalation of sevoflurane and nitrous oxide without muscle relaxants, and maintained with propofol, remifentanil, and pancuronium under pressure-controlled ventilation. The Airway Scope could not be inserted into her mouth, but her trachea was successfully intubated with a Macintosh laryngoscope. Dosages of anesthetics and fluid infusion rate were calculated first per ideal body weight. Then, infusion of propofol and remifentanil and administration of muscle relaxant were controlled by bispectral index, hemodynamics, and train-of-four response, respectively. Postoperative 12-h pressure-controlled ventilation and pain management by subcutaneous infusion of fentanyl and droperidol were successful. Subcutaneous heparin 5,000 units twice per day postoperatively did not induce thromboembolism.
Authors:
Tomoki Nishiyama; Yumiko Kohno; Keiko Koishi
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-22
Journal Detail:
Title:  Journal of anesthesia     Volume:  -     ISSN:  1438-8359     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Anesthesiology and Critical Care, Higashi Omiya General Hospital, 5-18 Higashi Omiya Minuma-ku, Saitama, Saitama, 337-0051, Japan, nishit-tky@umin.ac.jp.
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