Bale Emma, Berrecloth Richard
Alma Medical Products, 24a Monument Park, Chalgrove, OX44 7RW.
J Perioper Pract. 2010 Aug;20(8):294-9.
The authors have combined experience of over forty years working within the NHS and private hospitals as registered operating department practitioners. It is widely accepted that obesity is a growing problem in the populations of all developed and, increasingly, developing countries. It is also agreed that this sector of the population present specific challenges when required to undergo general anaesthesia. What is not so evident is a universal approach to assessing, predicting and overcoming these challenges. Furthermore, where there is the presentation of a clearly high risk patient, there can be limitations in optimizing the environment for reasons such as saving time, a lack of resources or sheer apathy. This article reviews the challenges, assessment and solutions available to the clinician faced with a high BMI patient with particular reference to the technique of ramping.
作者们拥有超过四十年在英国国民医疗服务体系（NHS）和私立医院担任注册手术部从业人员的工作经验。人们普遍认为，肥胖在所有发达国家的人口中都是一个日益严重的问题，并且在越来越多的发展中国家也是如此。人们还一致认为，这部分人群在需要接受全身麻醉时会带来特殊挑战。不太明显的是一种评估、预测和克服这些挑战的通用方法。此外，当出现明显的高风险患者时，由于节省时间、资源短缺或纯粹的冷漠等原因，在优化环境方面可能会存在限制。本文回顾了临床医生在面对高体重指数（BMI）患者时所面临的挑战、评估方法及解决方案，特别提及了斜坡卧位技术。
