Treating Obese Patients at Ambulatory Surgery Centers
Obese patients require special consideration during their ambulatory surgical and perioperative care, and only some procedures can be performed in ambulatory and office-based locations on obese patients. Some of these patients may have already had weight-reduction surgery and report to an ambulatory surgery center for a surgical procedure after significant weight-loss.
- Ambulatory surgical centers may have a defined weight limit before they accept patients for surgery. Patients must check with their surgeons about similar and other limitations.
- Make sure the center has appropriate “bariatric furniture” to allow the safe conduct of surgery and perioperative care. Obese patients should have the opportunity to discuss their care with an anesthesiologist before the procedure.
- During the pre-surgery meeting, the anesthesiologist will evaluate the patient for all the problems commonly present in obese patients, such as obstructive sleep apnea, diabetes, gastro-esophageal reflux disease, and high blood pressure.
- The patient should go over his or her medication list with the anesthesiologist and discuss those medications that need to be taken the night before and on the day of surgery.
- The anesthesia provider may ask a patient to bring his or her own CPAP/BI-PAP machine on the day of the procedure for use during the postoperative period. These machines help manage airway issues for patients when they sleep at night.
Proper attention to detail will help minimize problems and create easier perioperative ambulatory and office-based care for obese patients. Be sure to discuss any concerns you may have with your physician or anesthesiologist.