CAJ | 학술논문

病态肥胖症(morbid obesity,MO),特别是合并阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)患者的麻醉给麻醉医师提出了诸多挑战.充分的术前评估和围术期准备是患者平稳渡过围手术期的关键.MO影响多个重要器官,麻醉前评估除了病史及体格检查外,应着重了解循环和呼吸系统的问题,MO患者气管插管可能更困难,应详细评估气道,制定插管备选策略.此外,不同的药代动力学和药效学,围手术期及术后的管理也同样棘手.现通过1例MO患者的病例,讨论分析此类患者适合的麻醉方法和管理技术.
병태비반증(morbid obesity,MO),특별시합병조새성수면호흡잠정종합정(obstructive sleep apnea syndrome,OSAS)환자적마취급마취의사제출료제다도전.충분적술전평고화위술기준비시환자평은도과위수술기적관건.MO영향다개중요기관,마취전평고제료병사급체격검사외,응착중료해순배화호흡계통적문제,MO환자기관삽관가능경곤난,응상세평고기도,제정삽관비선책략.차외,불동적약대동역학화약효학,위수술기급술후적관리야동양극수.현통과1례MO환자적병례,토론분석차류환자괄합적마취방법화관리기술.
The anesthesiologist may be requested to deal with several challenges in morbid obesity (MO),especially combining obstructive sleep apnea hyponea syndrome (OSAS).It is a significant important to perform a thorough preoperative evaluation to identify potential risk factors related to anesthesia and adequately prepare for perioperative management.MO affects multiple vital organs.The preoperative evaluation of the consequences of obesity not only involves case history and physical examination,but also should focus on respiratory and cardiac systems.As intubation and maintenance of oxygenation may be particularly challenging,various strategies should be presented.In addition,different pharmacokinetic and pharmacodynamic drug regimen,perioperative and postoperative management may be also challenging.We reported a case,a patient who suffered from morbid obesity and underwent laparoscopic vertical banded gastroplasty,and analyzed anesthetic management.