Raphael Ibrahim J, Parmar Mayank, Mehrganpour Neema, Sharkey Peter F, Parvizi Javad
Department of Orthopedic Surgery, Rothman Institute, Philadelphia, PA, USA.
J Knee Surg. 2013 Apr;26(2):95-9. doi: 10.1055/s-0033-1333663. Epub 2013 Jan 28.
Obesity has been associated with osteoarthritis and increased morbidity and mortality. Most joint arthroplasty patients have a high body mass index (BMI). Some surgeons are reluctant to operate on obese patients due to technical difficulties and the anticipated higher complication rate. The purpose of this prospective study was to determine whether obesity is associated with longer operative times. We attended 100 consecutive primary total joint arthroplasties. Patients were divided into four groups depending on their BMI: the normal group (BMI: 18 to 24.9 kg/m2), the overweight group (BMI: 25 to 29.9 kg/m2), the obese group (BMI: 30 to 39.9 kg/m2), and the morbidly obese group (BMI ≥ 40 kg/m2). Anesthesia type and time, duration of surgery, time needed for scrubbing, draping, and transferring the patient to the operating table were all documented. The mean operative time for total hip arthroplasty (THA) was significantly increased in morbidly obese patients (R2 = 0.197, p = 0.003). The mean scrubbing time for total knee arthroplasty varied with BMI (p = 0.028). Time to administer spinal anesthesia was significantly increased in morbidly obese patients (R2 = 0.1466, p = 0.018). Morbid obesity is associated with a significant increase in the time needed to administer spinal anesthesia and the overall time needed to perform a THA.
肥胖与骨关节炎以及发病率和死亡率的增加有关。大多数关节置换手术患者的体重指数（BMI）较高。由于技术困难和预期的更高并发症发生率，一些外科医生不愿为肥胖患者进行手术。这项前瞻性研究的目的是确定肥胖是否与更长的手术时间相关。我们连续观察了100例初次全关节置换手术。根据患者的BMI将其分为四组：正常组（BMI：18至24.9kg/m²）、超重组（BMI：25至29.9kg/m²）、肥胖组（BMI：30至39.9kg/m²）和病态肥胖组（BMI≥40kg/m²）。记录麻醉类型和时间、手术持续时间、刷洗、铺巾以及将患者转移至手术台所需的时间。病态肥胖患者全髋关节置换术（THA）的平均手术时间显著增加（R² = 0.197，p = 0.003）。全膝关节置换术的平均刷洗时间随BMI而变化（p = 0.028）。病态肥胖患者给予脊髓麻醉的时间显著增加（R² = 0.1466，p = 0.018）。病态肥胖与给予脊髓麻醉所需时间以及进行THA所需的总时间显著增加有关。
