López-Martínez R

Language: Spanish
References: 32
Page: 111-116
PDF size: 470.14 Kb.

ABSTRACT

Obesity represents one of the greatest challenges in contemporary anesthesiology, with a prevalence reaching sixteen percent of the global adult population. This comprehensive review collects perioperative management of obese patients demands and multidisciplinary approach, recognizing the profound pathophysiological alterations characterizing this disease. Structural airway changes, significant reduction in functional residual capacity, and cardiovascular alterations associated, exponentially increase the risk of catastrophic complications during the perioperative period. Modern perioperative medicine has revolutionized obese patient management through innovative protocol incorporation, including ultrasonography as a fundamental multifaceted tool used for individualized positive end expiratory pressure (PEEP) titration through pulmonary scores, optimizing protective mechanical ventilation and minimizing postoperative atelectasis. Furthermore, ultrasound-guided regional anesthesia has experienced remarkable advancement, particularly in fascial blocks, which have consolidated as cornerstones of multimodal analgesia, enabling crucial opioid-sparing strategies in this vulnerable population. Contemporary anesthesiologists must prioritize comprehensive preoperative evaluation, individualized pharmacological optimization based on advanced pharmacokinetic models, and implementation of protocols like ERAS^®, transforming the prognosis of obese patients undergoing surgery into the most favorable outcome.

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