Brondeel Kimberley C, Lakatta Alexis C, Torres Grant B, Hurley Joshua J, Kunik Illan L, Haney Kaley F, Cornett Elyse M, Kaye Alan D
Department of Medicine, University of Texas Medical Branch, 301 University Blvd, Galveston, TX, USA.
Anesthesiology Resident, LSU Health New Orleans, 433 Bolivar St, New Orleans, LA, USA.
Saudi J Anaesth. 2022 Jul-Sep;16(3):306-313. doi: 10.4103/sja.sja_185_22. Epub 2022 Jun 20.
Obesity is a growing worldwide health hazard that is characterized by excess malnutrition. Excess food intake leads to dysregulated energy homeostasis and increased adiposity, activating pro-inflammatory physiologic pathways that can contribute to the chronic inflammatory state associated with many chronic illnesses. Obesity is a preventable illness, but its multifaceted etiology, including genetic, behavioral, and environmental variables, is critical to understanding its epidemiology and pathophysiology. Obesity is a critical predisposing factor for illnesses including type II diabetes, cardiovascular disease, and cancer, with higher morbidity and death. Obesity rates are rising, and so will the need for perioperative anesthesia for subjects with obesity. Obesity epidemiology, biochemistry, and pathophysiology are significant concepts in perioperative anesthesia management for subjects with obesity. To provide optimal intraoperative care for subjects with obesity, preoperative cardiovascular assessment for coronary artery disease and drug monitoring is required. Individuals suffering from obesity have significantly higher oxygen consumption rates and a higher risk of desaturation and surgical complications. Individuals suffering from obesity require specialized perioperative treatment related to higher prevalence of perioperative complications.
肥胖是一种在全球范围内日益严重的健康危害，其特征是营养过剩。过量的食物摄入会导致能量稳态失调和肥胖增加，激活促炎生理途径，这可能会导致与许多慢性疾病相关的慢性炎症状态。肥胖是一种可预防的疾病，但其多方面的病因，包括遗传、行为和环境变量，对于理解其流行病学和病理生理学至关重要。肥胖是包括II型糖尿病、心血管疾病和癌症在内的多种疾病的关键诱发因素，其发病率和死亡率更高。肥胖率正在上升，肥胖患者对围手术期麻醉的需求也会增加。肥胖的流行病学、生物化学和病理生理学是肥胖患者围手术期麻醉管理中的重要概念。为肥胖患者提供最佳的术中护理，需要对冠状动脉疾病进行术前心血管评估和药物监测。肥胖个体的耗氧率明显更高，发生去饱和和手术并发症的风险也更高。肥胖个体需要与围手术期并发症较高发生率相关的专门围手术期治疗。
