Date of Award

12-2012

Document Type

Independent Study

Degree Name

Master of Science (MS)

Abstract

Current estimates place over one-third of the adult population in the obese category. Obesity is associated with a number of pathophysiologic disturbances that complicate the anesthetic course for these patients. The increasing prevalence of obesity and the established positive outcomes for surgical weight loss therapies have led to obese patients presenting for surgery at a rapidly increasing rate. Obesity places the surgical patient at an increased risk for cardiovascular events, respiratory dysfunction, airway management difficulties and increased postoperative pain. It is imperative for the anesthesia provider to be aware of these risks, unique anesthesia considerations, along with alternative therapies, which include the use of dexmedetomidine as an adjunct to general anesthesia, for the obese adult surgical patient. A comprehensive evidenced based literature review was conducted regarding this topic. A physiologic framework was used to guide this independent project. Dexmedetomidine provides several benefits when used as an adjunct to general anesthesia in the obese population. Dexmedetomidine has been shown to reduce intraoperative inhaled anesthetic and opioid requirements, provide excellent postoperative pain control, reduce the incidence of cardiorespiratory events, and provide a better recovery from anesthesia compared to traditional anesthetic techniques. This study was designed to raise awareness of the physiologic and anesthetic considerations of obesity as well as the many benefits dexmedetomidine can provide as an adjunct to anesthesia. This infom1ation will allow the anesthesia provider to recognize the potential complications encountered in obesity and tailor an anesthetic plan of care in order to improve perioperative outcomes and delivery of anesthetic care. Keywords: dexmedetomidine, obesity, anesthesia adjunc

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