الفهرس 
Definition and Classification of ObesityOnly 14 pages are availabe for public view
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Abstract
obesity is a major health problem affecting every organ system and is associated with many health consequences including an increased risk for coronary artery disease, dyslipidemia, hypertension, diabetes mellitus, degenerative joint disease, gallbladder disease, obstructive sleep apnea, and socioeconomic and psychosocial impairment.
Weight reduction surgery is recommended as the best alternative treatment for extreme obese patients who cannot lose weight by diet, exercise, and weight loss medications. Bariatric surgery is considered as the only effective long-term treatment for patients with BMI ≥ 40 or ≥ 35 with comorbidities.
Bariatric surgery has severall advantages for the patients, it can help improve cardiovascular disease, hypertension, glucose intolerance, and Type 2 diabetes, dyslipidemia, and mortality.
As the risk of anaesthesia and surgery is higher in obese patients than the normal population, anaesthesiologists should be familiar with the clinical management of obese patients for all types of surgery, especially for weight reduction procedures. They must completely assess the patients before the surgery to identify anaesthesia related potential risk factors and prepare for management during the surgery. Induction and maintenance of anaesthesia and oxygenation, intubation, and pain management can be challenging in these patients. Moreover, obese patients are at a higher risk for postoperative complications.
Recommendations
1. Every hospital should nominate an anaesthetic lead for obesity.
2. Operating lists should include the patients weight and body mass index (BMI).
3. Experienced anaesthetic and surgical staff should manage obese patients.
4. Additional specialised equipment is necessary.
5. Central obesity and metabolic syndrome should be identified as risk factors.
6. Sleep disordered breathing and its consequences should always be considered in the obese.
7. Anaesthetising the patient in the operating theatre should be considered.
8. Regional anaesthesia is recommended as desirable but is often technically difficult and may be impossible to achieve.
9. A robust airway strategy must be planned and discussed, as desaturation occurs quickly in the obese patient and airway management can be difficult.
10. Use of the ramped or sitting position is recommended as an aid to induction and recovery.
11. Drug dosing should generally be based upon lean body weight and titrated to effect, rather than dosed to total body weight.
12. Caution is required with the use of long acting opioids and sedatives.
13. Neuromuscular monitoring should always be used, whenever, neuromuscular blocking drugs are used.
14. Depth of anaesthesia monitoring should be considered, especially when total intravenous anaesthesia is used in conjunction with neuromuscular blocking drugs.
15. Appropriate prophylaxis against venous thromboembolism (VTE) and early mobilisation are recommended since the incidence of venous thromboembolism is increased in the obese.
16. Postoperative intensive care support should be considered, but is determined more by co-morbidities and surgery than by obesity per se.