Obesity surgery
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Randomized Controlled Trial Clinical Trial
Laryngoscopy and morbid obesity: a comparison of the "sniff" and "ramped" positions.
The effect of patient position on the view obtained during laryngoscopy was investigated. ⋯ The "ramped" position is superior to the standard "sniff" position for direct laryngoscopy in morbidly obese patients.
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Associated or rare diseases, such as myasthenia gravis, introduce a challenge to the perioperative management of severely obese patients undergoing bariatric surgery. We report the surgical management and unique anesthetic approach to a 55-year-old morbidly obese woman with a complex past medical history that included myasthenia gravis, who underwent laparoscopic gastric bypass. ⋯ Continued perioperative anticholinesterase administration may have facilitated this successful outcome. We conclude that a diagnosis of myasthenia gravis does not mandate postoperative mechanical ventilation following laparoscopic gastric bypass.