Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Case report
Year : 2018 | Month : July | Volume : 12 | Issue : 7 | Page : UD01 - UD03

Laparoscopic Bariatric Surgery of Super-obese Patient with Intractable Anterior Abdominal Wall Cellulitis: A Rare Challenge to Anaesthesiologist

Himani Prashar, Kamakshi Garg, Sanyam Nandwani, Neeru Luthra, Palavi Garg

1. Senior Resident, Department of Anaesthesia, Dayanand Medical College and Hospital, Ludhiana, Punjab, India. 2. Associate Professor, Department of Anaesthesia, Dayanand Medical College and Hospital, Ludhiana, Punjab, India. 3. Senior Resident, Department of Surgery, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar, Punjab, India. 4. Associate Professor, Department of Anaesthesia, Dayanand Medical College and Hospital, Ludhiana, Punjab, India. 5. Junior Resident, Department of Anaesthesia, Dayanand Medical College and Hospital, Ludhiana, Punjab, India.

Correspondence Address :
Dr. Himani Prashar,
8156, Durgapuri Haibowal Kalan, Ludhiana-141001, Punjab, India.
E-mail: dr.himaniprashar@gmail.com

Abstract

Obesity has become an epidemic problem worldwide. Obesity and its related comorbidities present a variety of challenges to anaesthesiologist. Bariatric surgery is the best treatment modality for patients who do not respond to dietary restriction and medical management. An anaesthesiologist should be experienced enough to handle the airway, pain, fluid management and acidosis in the obese patients undergoing bariatric surgery. Laparoscopic vertical sleeve gastrectomy for weight loss was planned for a 48-year-old, super-obese male patient (weight 187 kg, height 155 cm, BMI 77 kg/m2) with anterior abdominal wall cellulitis which was not responding to antibiotics. On pre-operative examination, patient had a short thick neck, Grade 3 mallampati class, mild obstructive sleep apnoea and hypertension. Patient was given trial of Continuous Positive Airway Pressure (CPAP) in pre-operative period. Induction of anaesthesia was done in the semi-sitting position. Maintenance was provided with desflurane, oxygen/air mixture and dexmedetomidine infusion. However, patient had delayed recovery. Extubation was done on return of spontaneous ventilation and when patient was awake. He was initially put on CPAP and later on, reintubation was done as he was unable to maintain saturation in immediate post-operative period.

Keywords

Continuous positive airway pressure, Laparoscopic vertical sleeve gastrectomy, Obesity, Weight loss

How to cite this article :

Himani Prashar, Kamakshi Garg, Sanyam Nandwani, Neeru Luthra, Palavi Garg. LAPAROSCOPIC BARIATRIC SURGERY OF SUPER-OBESE PATIENT WITH INTRACTABLE ANTERIOR ABDOMINAL WALL CELLULITIS: A RARE CHALLENGE TO ANAESTHESIOLOGIST. Journal of Clinical and Diagnostic Research [serial online] 2018 July [cited: 2018 Jul 23 ]; 12:UD01-UD03. Available from
http://jcdr.net/back_issues.asp?issn=0973-709x&year=2018&month=July&volume=12&issue=7&page=UD01-UD03&id=11804

DOI and Others

DOI: 10.7860/JCDR/2018/27966.11804

Date of Submission: Mar 02, 2017
Date of Peer Review: Apr 04, 2017
Date of Acceptance: May 18, 2018
Date of Publishing: Jul 01, 2018

FINANCIAL OR OTHER COMPETING INTERESTS: None.

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