Original scientific paper

IDENTIFICATION OF RESPIRATORY RISK PARAMETERS IN OBESE ORAL SURGICAL PATIENTS

VLASTA KLARIĆ orcid.org/0000-0002-0105-6108 ; Dubrava University Hospital, Department of Anesthesiology, Resuscitation and Intensive Care, Zagreb, Croatia
ANDREJ ŠRIBAR ; Dubrava University Hospital, Department of Anesthesiology, Resuscitation and Intensive Care, Zagreb, Croatia
MORENA MILIĆ ; Dubrava University Hospital, Department of Anesthesiology, Resuscitation and Intensive Care, Zagreb, Croatia
VLASTA MERC ; Dubrava University Hospital, Department of Anesthesiology, Resuscitation and Intensive Care, Zagreb, Croatia
IVAN ZAJC ; University of Zagreb, School of Dental Medicine and Dubrava University Hospital, Department of Oral Surgery, Zagreb, Croatia
JASMINKA PERŠEC orcid.org/0000-0002-3777-8153 ; Dubrava University Hospital, Department of Anesthesiology, Resuscitation and Intensive Care, University of Zagreb, School of Dental Medicine, Zagreb, Croatia

Abstract

Obesity, defi ned as body mass index (BMI) between 30 and 39.9 kg/m2, and morbid obesity, with BMI of more than 40 kg/m2 is a multisystem, chronic, proinfl ammatory disorder with a worldwide increasing prevalence called “globesity”. There is a known signifi cant increase in perioperative complications in obese patients. Oral surgeries under general endotracheal anesthesia pose special challenge in obese patients. The aim of the study was to evaluate the risk of postoperative
pulmonary complications (PPC), preoperative dyspnea score and their correlation with body mass index (BMI) among obese patients scheduled for oral surgical procedures under general anesthesia. Following permission by the Ethics Committee and signed written informed consent, 75 obese patients (age 30-65 and ASA status II-III) were involved. The PPC risk was determined by ARISCAT score and dyspnea by modifi ed Borg score. The mean BMI was 35.6 (SD 5.6),
with no gender difference. Patients had the abdominal obesity type with the mean waist-to-hip (W/H) ratio greater than 1.1 (female 0.99±0.19 and male 1.11±0.18). The mean neck circumference was 54.2 (SD 6.9) cm, signifi cantly higher in males (p=0.003). There was signifi cant positive correlation of ARISCAT score (r=0.57; p=0.001) and preoperative degree of dyspnea (r=0.51; p=0.001) with BMI, and of neck circumference with W/H ratio (r=0.37; p=0.01). The results showed positive correlation between the PPC risk determined and preoperative dyspnea level (r=0.34; p=0.002). Identifi cation of respiratory risk parameters in obese patients and their interdependence proved to be of clinical interest. Preoperative assessment of PPC risk and dyspnea level at rest should be part of the standard preoperative protocol for oral surgical procedures, especially in one-day surgery.

Keywords

obesity; oral surgical procedures; postoperative pulmonary complications; general anesthesia; dyspnea

Hrčak ID:

193701

URI

https://hrcak.srce.hr/193701

Publication date:

15.2.2018.

Article data in other languages: croatian

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