Obesity surgery
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Randomized Controlled Trial
Continuous Transversus Abdominis Plane Blocks via Laparoscopically Placed Catheters for Bariatric Surgery.
The objective of the present study is to evaluate postoperative analgesic outcome of the continuous bilateral transversus abdominis plane (TAP) block using bupivacaine infusion through an epidural catheter inserted through laparoscopic ports. ⋯ Continuous bupivacaine TAP block provided through an epidural catheter passed through laparoscopic ports improved postoperative outcome of LSG in terms of reduced postoperative pain scores, sparing morphine consumption, and early recovery items.
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Helping patients determine which type of bariatric surgery, Roux-en-Y gastric bypass (RYGB) or vertical sleeve gastrectomy (VSG), may be the best treatment can be challenging. This study investigated psychological correlates and their influence on weight loss for patients who underwent RYGB or VSG. ⋯ Patients who are psychologically higher functioning are more likely to complete the evaluation process and undergo bariatric surgery. For patients who had surgery, psychological correlates were not associated with weight loss outcome for either RYGB or VSG. Implications for surgical choice are discussed.
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Observational Study
Perioperative Analgesia for Fast-Track Laparoscopic Bariatric Surgery.
Postoperative pain and analgesia present challenges in bariatric surgery patients. Multimodal analgesia may provide better efficacy, less complications and expedite fast-track bariatric surgical care. There are no studies of the broader topic of perioperative analgesia and the overall impact. This study highlights the impact of multimodal intraoperative analgesia on fast-track bariatric surgery. ⋯ Multimodal intraoperative analgesia provides better postoperative analgesia, less complications and better perioperative outcomes and facilitates fast-track bariatric surgical care. Tramadol is suitable, efficacious and safe and associated with the best perioperative outcomes in bariatric surgery patients.
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Compared to healthy individuals, obese have significantly higher systolic and diastolic blood pressure, mean arterial pressure, heart rate, and cardiac output. The aim of this study was to evaluate cardiovascular hemodynamic changes before and 3 months after bariatric surgery. ⋯ Eighty subjects were included in this study, respectively, 56 obese patients scheduled for bariatric surgery and 24 healthy individuals. Baseline hemodynamic measurements showed significant differences in cardiac output (6.5 ± 1.6 versus 5.7 ± 1.6 l/min, p = 0.046), mean arterial pressure (107 ± 19 versus 89 ± 11 mmHg, p = 0.001), systolic (134 ± 24 versus 116 ± 18 mmHg, p = 0.001) and diastolic blood pressure (89 ± 17 versus 74 ± 10 mmHg, p = 0.001), and heart rate (87 ± 12 versus 76 ± 14 bpm, p = 0.02) between obese and healthy subjects. Three months after surgery, significant changes occurred in mean arterial pressure (89 ± 17 mmHg, p = 0.001), systolic (117 ± 24 mmHg, p = 0.001) and diastolic blood pressure (71 ± 15 mmHg, p = 0.001), stroke volume (82.2 ± 22.4 ml, p = 0.03), and heart rate (79 ± 17 bpm, p = 0.02) CONCLUSIONS: Three months after bariatric surgery, significant improvements occur in hemodynamic variables except cardiac output and cardiac index, in the patient group.
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This study aims to investigate weight regain and the associated variables 10 years after Roux-en-Y gastric bypass. ⋯ Patients submitted to Roux-en-Y gastric bypass presented weight regain, which increased over time. Age, iron deficiency, and time since surgery were associated with weight regain in the long-term follow-up.