Obesity surgery
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Randomized Controlled Trial Comparative Study Clinical Trial
Nitrous oxide and laparoscopic bariatric surgery.
Nitrous oxide (N2O) is frequently used to supplement more potent anesthetic agents. One side-effect of N2O is its ability to expand an air-containing space. We investigated if N2O adversely affected operating conditions by distending normal bowel during laparoscopic bariatric procedures. ⋯ We found that using N2O did not cause noticeable bowel distention during laparoscopic bariatric procedures of relatively short duration.
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Comparative Study
The Bariatric Quality of Life index: a measure of well-being in obesity surgery patients.
Quality of life (QoL) is considered to be the true measure for the effectiveness of a surgical procedure, but there are only a few validated instruments available for bariatric surgery. Therefore, a new diseasespecific 30-item instrument was created, which was called Bariatric Quality of Life (BQL) questionnaire. ⋯ The BQL questionnaire is a validated instrument ready for clinical use.
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Case Reports
Topical benzocaine (Hurricaine) induced methemoglobinemia during endoscopic procedures in gastric bypass patients.
Methemoglobinemia results from oxidation of ferrous to ferric iron in hemoglobin. In addition to a functional anemia, methhemoglobinemia causes the O2-binding affinity of the remaining O2 sites in the hemoglobin tetramer to increase; essentially shifting the oxyhemoglobin dissociation curve to the left and decreasing O2 delivery. Patients develop profound cyanosis unresponsive to O2 when methemoglobin (MHb) levels exceed 10%. It can be lethal if levels exceed 70%. Benzocaine 20% (Hurricaine) spray, commonly used in endoscopy (EGD) can cause methemoglobinemia. We report our experience. ⋯ Topical benzocaine 20% (Hurricaine) spray used in EGDs gets absorbed and can cause methemoglobinemia. Sprays should be limited to 1 second. Prompt treatment with 1% methylene blue IV can be life-saving.