Anesthesia for the morbidly obese parturient

Current Opinion in Anaesthesiology

Volumn 22, Issue 3, 2009, Pages 341-346

  Roofthooft, Eva ^a  

^a ZNA Middelheim   (Belgium)

Author keywords

Failed intubation; Maternal obesity; Obesity

Indexed keywords

NITROUS OXIDE; OPIATE; SUXAMETHONIUM;

ACID ASPIRATION; AIRWAY RESISTANCE; ANESTHESIA COMPLICATION; ANESTHESIA INDUCTION; ARTIFICIAL VENTILATION; ASPIRATION; BODY MASS; CARDIOVASCULAR RISK; CARDIOVASCULAR SYSTEM; CEREBROVASCULAR ACCIDENT; CESAREAN SECTION; CORONARY ARTERY DISEASE; DIABETES MELLITUS; EPIDURAL CATHETER; EXPIRATORY RESERVE VOLUME; FUNCTIONAL RESIDUAL CAPACITY; GENERAL ANESTHESIA; HIATUS HERNIA; HUMAN; HYPERLIPIDEMIA; HYPERTENSION; INCIDENCE; INTUBATION; LABOR COMPLICATION; MACROSOMIA; MORBID OBESITY; OBSTETRIC ANALGESIA; OXYGENATION; PHYSIOLOGY; PREGNANCY; PREGNANCY COMPLICATION; PREVALENCE; PRIORITY JOURNAL; PULMONARY ASPIRATION; REGIONAL ANESTHESIA; RESPIRATORY FUNCTION; RESPIRATORY SYSTEM; REVIEW; RISK ASSESSMENT; RISK FACTOR; SHOULDER DYSTOCIA; STOMACH CONTENT; STOMACH EMPTYING;

ADULT; ANALGESIA, OBSTETRICAL; CESAREAN SECTION; FEMALE; HUMANS; OBESITY, MORBID; PREGNANCY; PREGNANCY COMPLICATIONS;

EID: 67649509449     PISSN: 09527907     EISSN: None     Source Type: Journal    
DOI: 10.1097/ACO.0b013e328329a5b8     Document Type: Review

References (69)

1. Sapathy HK, Fleming A, Frey D, et al. Maternal obesity and pregnancy. Postgrad Med 2008; 120:E01-E09.
2. Ogden CL, Carroll MD, Mcdowell MA, Flegal KM. Obesity among adults in the United States: no change since 2003-2004. NCHS data brief no. 1. Hyattsville, MD: National Center for Health Statistics; 2007.
3. Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and trends in obesity among US adults, 1999-2000. JAMA 2002; 288:1723- 1727.
4. Arendas K, Qiu Q, Gruslin A. Obesity in pregnancy: preconceptional to postpartum consequences. J Obstet Gynaecol Can 2008; 30:477- 488.
5. Ray A, Hildreth A, Esen Ul. Morbid obesity and intra-partum care. J Obstet Gynaecol 2008; 28:301 -304.
6. Dixit A, Girling JC. Obesity and pregnancy. J Obstet Gynaecol 2008; 28:14- 23.
7. Rasmussen SA, Chu SY, Kim SY, et al. Maternal obesity and risk of neural tube defects: a meta-analysis. Am J Obstet Gynecol 2008; 198:611- 619.
8. Chu SY, Bachman DJ, Callaghan WM, et al. Association between obesity during pregnancy and increased use of healthcare. N Engl J Med 2008; 358:1444-1453.
9. Mhyre JM, Greenfield MLVH, Polley LS. Survey of obstetric providers' views on the anesthetic risks of maternal obesity. Int J Obstet Anesth 2007; 16:316-322.
10. Lewis G. The Confidential Enquiry into Maternal and Child Health (CEMACH). Why mothers die 2000-2002.
11. Lewis G. The Confidential Enquiry into Maternal and Child Health (CEMACH). Saving mother's lives: reviewing maternal deaths to make motherhood safer: 2003-2005.
12. Maltby JR, Pytka S, Watson NC, et al. Drinking 300 ml of clear fluid two hours before surgery has no effect on gastric fluid volume and pH in fasting and nonfasting obese patients. Can J Anaesth 2004; 51:111 -115.
13. Juvin P, Fevre G, Merouche M, et al. Gastric residue is not more copious in obese patients. Anesth Analg 2001; 93:1621 -1622.
14. Wong CA, McCarthy PJ, Fitzgerald PC, et al. Gastric emptying of water in obese pregnant women at term. Anesth Analg 2007; 105:751-755.
15. Barak N, Ehrenpreis ED, Harrison JR, Sitrin MD. Gastro-oesophagal reflux disease in obesity: pathophysiological and therapeutic considerations. Obes Rev 2002; 3:9-15.
16. Hawthorne L, Wilson R, Lyons G, Dresner M. Failed intubation revisited: a 17-yr experience in a teaching maternity unit. Br J Anaesth 1996; 76:680-684.
17. Bernardo PD, Jenkins JG. Failed tracheal intubation in obstetrics: a 6 year review in a UK region. Anaesthesia 2000; 55:685-694.
18. Samsoon GL, Young JR. Difficult tracheal intubation: a retrospective study. Anaesthesia 1987; 42:487-490.
19. Juvin Ph, Lavaut E, Dupont H, et al. Difficult tracheal intubation is more common in obese than in lean patients. Anesth Analg 2003; 97:595-600.
20. Rahman K, Jenkins JG. Failed tracheal intubation in obtetrics: no more frequent but still badly managed. Anaesthesia 2005; 60:168-171.
21. D'Angelo R, Dewan DD. Obesity. In: Chestnut DH, editor. Obstetric anaesthesia: principles and practice, 3rd ed. Philadelphia: Elsevier Mosby; 2004. pp. 893-903.
22. Hood DD, Dewan DM. Anesthetic and obstetric outcome in morbidly obese parturients. Anesthesiology 1993; 79:1210-1218.
23. Merah NA, Foulkes-Crabbe DJ, Kushimo OT, et al. Prediction of difficult laryngoscopy in a population of Nigerian obstetric patients. West Afr J Med 2004; 23:38-41.
24. Naguib M, Malabarey T, Alsatli RA, et al. Predictive models for difficult laryngoscopy and intubation. A clinical, radiologic and three-dimensional computer imaging study. Can J Anesth 1999; 46:748-759.
25. Wissler RN. Obesity in the parturient: an increasing burden. Int J Obstet Anesth 2008; 17:1-2.
26. Lee JJ, Larsen RH, Buckley JJ, et al. Pulmonary function and its correlation to the degree of obesity in 294 patients. Anesth Rev 1981; 54:325-328.
27. Eng M, Butler J, Bonica JJ. Respiratory function in pregnant obese women. Am J Obstet Gynecol 1975; 123:241-245.
28. Unterborn J. Pulmonary function testing in obesity, pregnancy and extremes of body habitus. Clin Chest Med 2001; 22:759-767.
29. Dempsey JA, Reddan W, Rankin J, et al. Alveoalr arterial gas exchange during muscle work in obesity. J Appl Physiol 1996; 21:1807-1814.
30. Soens MA, Birnbach DJ, Ranasinghe JS, Van Zundert A. Obstetric anaesthesia for the obese and morbidly obese patient: an ounce of prevention is worth more than a pound of treatment: review article. Acta Anaesthesiol Scand 2008; 52:6-19.
31. Saravanakumar K, Rao SG, Cooper GM. Obesity and obstetric anaesthesia: review article. Anaesthesia 2006; 61:36-48.
32. Heslehurst N, Ells U, Simpson H, et al. Trends in maternal obesity incidence rates, demographic predictors, and health inequalities in 36 821 women over a 15 year period. Br J Obstet Gynaecol 2007; 114:187-194.
33. Kiran TSU, Hemmadi S, Bethal J, Evans J. Outcome of pregnancy in a woman with an increased body mass index. Br J Obstet Gynaecol 2005; 112:768- 772.
34. Kanagalingam MG, Forouhi NG, Greer IA, Sattar N. Changes in booking body mass index over a decade: retrospective analysis from a Glasgow Maternity Hospital. Br J Obstet Gynaecol 2005; 112:1431-1433.
35. Department of Health. Health Survey for England 2003. London: HMSO; 2003.
36. Department of Health, London. Health Survey for England 2002: trends. London: HMSO; 2002. http://www.dh.gov.uk/assetRoot/04/06/60/70/ 04066070.xls.
37. Guelinckx I, Devlieger R, Becjers K, Vansant G. Maternal obesity: pregnancy complications, gestational weight gain and nutrition. Obes Rev 2008; 9:140-150.
38. Roberts RB, Shirley MA. Reducing the risk of acid aspiration during cesarian section. Anesth Analg 1974; 53:859-868.
39. Vaughan RW, Bauer S, Wise L. Volume and pH of gastric juice in obese patients. Anesthesiology 1975; 43:686-689.
40. Chang AB. Physiologic changes of pregnancy. In: Chesthut DH, editor. Obstetric anesthesia: principles and practice, 3rd ed. Philadelphia: Elsevier Mosby; 2004. pp. 15-36.
41. Veille JC, Hanson R. Obesity, pregnancy, and left ventricular functioning during the third trimester. Am J Obstet Gynecol 1994; 171:980-983.
42. Vasan RS. Cardiac function and obesity. Heart 2003; 89:1127-1129.
43. Tomoda S, Tamura T, Sudo Y, et al. Effects of obesity on pregnant women: maternal hemodynamic change. Am J Perinat 1996; 13:73-78.
44. Ramsay JE, Ferrell WR, Crawford L, et al. Maternal obesity is associated with dysregulation of metabolic, vascular and inflammatory pathways. J Clin Endocrinol Metab 2002; 87:4231-4237.
45. Kaufman I, Bondy R, Benjamin A. Peripartum cardiomyopathy and thromboembolism: anesthetic management and clinical cause of an obese, diabetic patient. Can J Anaesth 2003; 50:161-165.
46. Tseuda K, Debrand M, Zeok SS, et al. Obesity supine death syndrome: reports of two morbidly obese patients. Anesth Analg 1979; 58:345-347.
47. Carson MP, Powrie RO, Rosene-Montella K. The effect of obesity and position on heart rate in pregnancy. J Matern Fetal Neonatal Med 2002; 11:40-45.
48. Hess PE, Pratt SD, Luca TP, et al. Predictors of breakthrough pain during labour epidural analgesia. Anesth Analg 2001; 93:414-418.
49. Melzack R, Kinch R, Dobkin P, et al. Severity of labour pain: influence of physical as well as physiologic variables. Can Med Assoc J 1984; 130:579- 584.
50. Ranta P, Jouppila P, Spalding M, et al. The effect of maternal obesity on labor and labor pain. Anaesthesia 1995; 50:322-326.
51. Elbourne D, Wiseman RA. Types of intra-muscular opioids for maternal pain relief in labour. Cochrane Database Syst Rev 2000:CD001237.
52. Howell CJ. Epidural versus nonepidural analgesia for pain relief in labour. Cochrane Database Syst Rev 2000:CD000331.
53. von Ungern-Sternberg BS, Regli A, Bucher E, et al. The effect of epidural analgesia in labour on maternal respiratory function. Anaesthesia 2004; 59:350-353.
54. Cooper GM, McClure JH. Anaesthesia chapter from saving mothers' lives: reviewing maternal deaths to make pregnancy safer. Br J Anaesth 2008;100:17-22.
55. Clincksales CP, Greenfield MLVH, Vanarase M, Polley LS. An observational study of the relationship between lumbar epidural space depth and body mass index in Michigan parturients. Int J Obstet Anesth 2007; 16:323-327.
56. Jordan H, Perlow MD, Mark A, et al. Massive maternal obesity on perioperative cesarean morbidity. Am J Obstet Gynecol 1994; 170:560-565.
57. Bahar M, Chanimov M, Cohen ML, et al. Teh lateral recumbent head-down position decreases the incidence of epidural venous puncture during catheter insertion in obese parturients. Can J Anaesth 2004; 51:577-580.
58. Hamza J, Smida H, Benhamou D, Cohen SE. Parturient's posture during epidural puncture affects the distance from skin to epidural space. J Clin Anaesth 1995; 7:1-4.
59. Bank JH, Kim JH, Lee JS, et al. Computed tomography study of the lumbar (L3-L4) epidural depth and its relationship to physical measurements in young adult men. Reg Anaesth Pain Med 1998; 23:262-265.
60. Grau T, Bartusseck E, Conradi R, et al. Ultrasound imaging improves learning curves in obstetric epidural anesthesia: a preliminary study. Can J Anesth 2003; 50:1047-1050.
61. Grau T, Leoplod RW, Horter J, et al. The lumbar epidural space in pregnancy: visualisation by ultrasonography. Br J Anaesth 2001; 86:798-804.
62. Carvalho JCA. Ultrasound-facilitated epidurals and spinals in obstetrics. Anesthesiol Clin 2008; 26:145-158.
63. Wasson C. Failed epidural in an obese patient: blame it on Pythagoras. Anaesthesia 2000; 56:585-610.
64. Faheem N, Sarwar N. Sliding of the skin over subcutaneous tissue is another important factor in epidural catheter migration. Can J Anesth 2002; 49:634.
65. Heslehurst N, Simpson H, Ells U, et al. The impact of maternal BMI status on pregnancy outcomes with immediate short-term obstetric resource implications: a meta-analysis. Obes Rev 2008; 9:635-683.
66. Hawkins JL. Anaesthesia-related maternal mortality. Clin Obstet Gynecol 2003; 46:679-687.
67. Collins JS, Lemmens HJ, BrodskyJB, et al. Laryngoscopy and morbid obesity: a comparison of the sniff and ramped positions. Obes Surg 2004; 14:1171 - 1175.
68. McDonnell NJ, Paech MJ. The management of a super morbidly obese parturient delivering twins by caesarean section. Anaesth Intensive Care 2007; 35:979-983.
69. Panni MK, Columb MO. Obese parturients have lower epidural local anaesthetic requirements for analgesia in labour. Br J Anaesth 2006; 96:106-110.