Obstetric anesthesia for the obese and morbidly obese patient: An ounce of prevention is worth more than a pound of treatment

Mieke A. Soens, David Birnbach, Jayanthie Ranasinghe, André Van Zundert

Research output: Contribution to journalArticle

112 Citations (Scopus)

Abstract

Background: The incidence of obesity has been dramatically increasing across the globe. Anesthesiologists, are increasingly faced with the care for these patients. Obesity in the pregnant woman is associated with a broad spectrum of problems, including dramatically increased risk for cesarean delivery, diabetes, hypertension and pre-eclampsia. A thorough understanding of the physiology, associated conditions and morbidity, available options for anesthesia and possible complications is therefore important for today's anesthesiologist. Methods: This is a personal review in which different aspects of obesity in the pregnant woman, that are relevant to the anesthesiologist, are discussed. An overview of maternal and fetal morbidity and physiologic changes associated with pregnancy and obesity is provided and different options for labor analgesia, the anesthetic management for cesarean delivery and potential post-partum complications are discussed in detail. Results and conclusion: The anesthetic management of the morbidly obese parturient is associated with special hazards. The risk for difficult or failed intubation is exceedingly high. The early placement of an epidural or intrathecal catheter may overcome the need for general anesthesia, however, the high initial failure rate necessitates critical block assessment and catheter replacement when indicated.

Original languageEnglish
Pages (from-to)6-19
Number of pages14
JournalActa Anaesthesiologica Scandinavica
Volume52
Issue number1
DOIs
StatePublished - Jan 1 2008

Fingerprint

Obstetrical Anesthesia
Obesity
Anesthetics
Pregnant Women
Catheters
Morbidity
Therapeutics
Pre-Eclampsia
Intubation
Analgesia
General Anesthesia
Patient Care
Anesthesia
Mothers
Parturition
Hypertension
Pregnancy
Incidence
Anesthesiologists

Keywords

  • Analgesia
  • Anesthesia
  • Cesarean
  • Labor
  • Obesity

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Obstetric anesthesia for the obese and morbidly obese patient : An ounce of prevention is worth more than a pound of treatment. / Soens, Mieke A.; Birnbach, David; Ranasinghe, Jayanthie; Van Zundert, André.

In: Acta Anaesthesiologica Scandinavica, Vol. 52, No. 1, 01.01.2008, p. 6-19.

Research output: Contribution to journalArticle

@article{8893c4098f3b4623abb1536273e87ad6,
title = "Obstetric anesthesia for the obese and morbidly obese patient: An ounce of prevention is worth more than a pound of treatment",
abstract = "Background: The incidence of obesity has been dramatically increasing across the globe. Anesthesiologists, are increasingly faced with the care for these patients. Obesity in the pregnant woman is associated with a broad spectrum of problems, including dramatically increased risk for cesarean delivery, diabetes, hypertension and pre-eclampsia. A thorough understanding of the physiology, associated conditions and morbidity, available options for anesthesia and possible complications is therefore important for today's anesthesiologist. Methods: This is a personal review in which different aspects of obesity in the pregnant woman, that are relevant to the anesthesiologist, are discussed. An overview of maternal and fetal morbidity and physiologic changes associated with pregnancy and obesity is provided and different options for labor analgesia, the anesthetic management for cesarean delivery and potential post-partum complications are discussed in detail. Results and conclusion: The anesthetic management of the morbidly obese parturient is associated with special hazards. The risk for difficult or failed intubation is exceedingly high. The early placement of an epidural or intrathecal catheter may overcome the need for general anesthesia, however, the high initial failure rate necessitates critical block assessment and catheter replacement when indicated.",
keywords = "Analgesia, Anesthesia, Cesarean, Labor, Obesity",
author = "Soens, {Mieke A.} and David Birnbach and Jayanthie Ranasinghe and {Van Zundert}, Andr{\'e}",
year = "2008",
month = "1",
day = "1",
doi = "10.1111/j.1399-6576.2007.01483.x",
language = "English",
volume = "52",
pages = "6--19",
journal = "Acta Anaesthesiologica Scandinavica",
issn = "0001-5172",
publisher = "Blackwell Munksgaard",
number = "1",

}

TY - JOUR

T1 - Obstetric anesthesia for the obese and morbidly obese patient

T2 - An ounce of prevention is worth more than a pound of treatment

AU - Soens, Mieke A.

AU - Birnbach, David

AU - Ranasinghe, Jayanthie

AU - Van Zundert, André

PY - 2008/1/1

Y1 - 2008/1/1

N2 - Background: The incidence of obesity has been dramatically increasing across the globe. Anesthesiologists, are increasingly faced with the care for these patients. Obesity in the pregnant woman is associated with a broad spectrum of problems, including dramatically increased risk for cesarean delivery, diabetes, hypertension and pre-eclampsia. A thorough understanding of the physiology, associated conditions and morbidity, available options for anesthesia and possible complications is therefore important for today's anesthesiologist. Methods: This is a personal review in which different aspects of obesity in the pregnant woman, that are relevant to the anesthesiologist, are discussed. An overview of maternal and fetal morbidity and physiologic changes associated with pregnancy and obesity is provided and different options for labor analgesia, the anesthetic management for cesarean delivery and potential post-partum complications are discussed in detail. Results and conclusion: The anesthetic management of the morbidly obese parturient is associated with special hazards. The risk for difficult or failed intubation is exceedingly high. The early placement of an epidural or intrathecal catheter may overcome the need for general anesthesia, however, the high initial failure rate necessitates critical block assessment and catheter replacement when indicated.

AB - Background: The incidence of obesity has been dramatically increasing across the globe. Anesthesiologists, are increasingly faced with the care for these patients. Obesity in the pregnant woman is associated with a broad spectrum of problems, including dramatically increased risk for cesarean delivery, diabetes, hypertension and pre-eclampsia. A thorough understanding of the physiology, associated conditions and morbidity, available options for anesthesia and possible complications is therefore important for today's anesthesiologist. Methods: This is a personal review in which different aspects of obesity in the pregnant woman, that are relevant to the anesthesiologist, are discussed. An overview of maternal and fetal morbidity and physiologic changes associated with pregnancy and obesity is provided and different options for labor analgesia, the anesthetic management for cesarean delivery and potential post-partum complications are discussed in detail. Results and conclusion: The anesthetic management of the morbidly obese parturient is associated with special hazards. The risk for difficult or failed intubation is exceedingly high. The early placement of an epidural or intrathecal catheter may overcome the need for general anesthesia, however, the high initial failure rate necessitates critical block assessment and catheter replacement when indicated.

KW - Analgesia

KW - Anesthesia

KW - Cesarean

KW - Labor

KW - Obesity

UR - http://www.scopus.com/inward/record.url?scp=37549047257&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=37549047257&partnerID=8YFLogxK

U2 - 10.1111/j.1399-6576.2007.01483.x

DO - 10.1111/j.1399-6576.2007.01483.x

M3 - Article

C2 - 18173431

AN - SCOPUS:37549047257

VL - 52

SP - 6

EP - 19

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 1

ER -