GENERAL ANESTHESIA FOR METABOLIC SURGERY IN OBESE PATIENTS

Abstract

The use of general anesthesia in metabolic surgeries for obese patients is a topic of critical relevance in modern medicine. Obesity, an increasingly prevalent health condition around the world, is often associated with serious comorbidities and significant impacts on quality of life. Metabolic surgery, which seeks to treat obesity and its comorbidities, has become an important therapeutic option. In this context, the choice of general anesthesia is a crucial decision, as it involves safety and efficacy considerations for a group of patients that presents unique challenges. Objective: to comprehensively examine and analyze the use of general anesthesia in metabolic surgeries performed on obese patients. Methodology: This systematic review strictly followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. To collect data, three important databases were consulted: PubMed, Scielo and Web of Science. The descriptors used in the search were: "obesity," "metabolic surgery," "general anesthesia," "surgical outcomes," and "complications.” Inclusion criteria: Peer-reviewed articles, clinical studies and systematic reviews published by the deadline of the review, studies written in English, studies that address the use of general anesthesia in metabolic surgeries performed on obese patients. Exclusion criteria: Studies not related to the topic, studies in languages other than English and articles without access to the full text. Results: 15 articles were selected. The systematic review revealed several relevant topics in the context of general anesthesia in metabolic surgeries for obese patients. The main results found include the prevalence of the use of general anesthesia in metabolic surgeries, comorbidities associated with obesity that may affect the choice of anesthesia, pharmacokinetic and pharmacodynamic considerations when administering general anesthesia in obese patients, specific perioperative complications and their risk factors and surgical outcomes and impact on improving metabolic conditions. Conclusion: In summary, this systematic review highlights the critical importance of choosing general anesthesia in metabolic surgeries for obese patients. Although general anesthesia offers advantages in terms of airway control and patient immobilization, it also brings significant challenges due to the comorbidities and unique physiological characteristics of obese patients. Understanding these challenges and the search for personalized anesthesia strategies are essential to optimize the safety and effectiveness of these procedures, thus improving the quality of life and health of obese patients undergoing metabolic surgery.