Analysis of comorbidity and anesthesia technique in patients undergoing bariatric surgery at the University Clinical Center of Serbia

Abstract

Introduction/Objective Altered physiology and metabolism of obese patients represents a big challenge for the anesthesiologist. The objectives of the study are to investigate numbers of comorbidities, choice of anesthesia techniques, intraoperative, and postoperative complications between bariatric and non-bariatric patients.

Methods This retrospective study included 469 patients. The study group of patients included obese patients with body mass index ≥ 30. Control Group included patients in whom elective laparoscopic cholecystectomy was performed, on the same day as bariatric surgery in Control Group.

Results The study group included 235 patients who underwent bariatric surgery, while control group included 234 patients. More patients in study group had comorbidities compared with Control Group (84.4% vs. 63.2%, p < 0.001). In the study group, total intravenous anesthesia and target control anesthesia were statistically significant more delivered than in the Control Group (74% vs. 0.9%, p < 0.001; 7.2% vs. 1.7, p < 0.001, respectively). Difficult intubation was statistically significant more in Control Group (5.6% vs. 0.9%, p = 0.004). There was a statistically significant difference in the incidence of intraoperative desaturation and hypotension during induction of anesthesia between the study and Control Group (9.8% vs. 2.1%, p < 0.001; 14.5% vs. 2.1, p < 0.001, respectively). There was statistically significant difference between the study and control group in minor complication according Clavien–Dindo classification, (20.8% vs. 5.1%, p < 0.001).

Conclusion Obesity is associated with higher number of comorbidities and intraoperative complications. There was no statistically difference in major postoperative complications between bariatric and non-bariatric patients.

Keywords: obesity; bariatric surgery; comorbidities; body mass index