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Influence of obesity on surgical regional anesthesia in the ambulatory setting: an analysis of 9,038 blocks.

Publication ,  Journal Article
Nielsen, KC; Guller, U; Steele, SM; Klein, SM; Greengrass, RA; Pietrobon, R
Published in: Anesthesiology
January 2005

BACKGROUND: Regional anesthesia is increasing in popularity for ambulatory surgical procedures. Concomitantly, the prevalence of obesity in the United States population is increasing. The objective of the present investigation was to assess the impact of body mass index (BMI) on patient outcomes after ambulatory regional anesthesia. METHODS: This study was based on prospectively collected data including 9,038 blocks performed on 6,920 patients in a single ambulatory surgery center. Patients were categorized into three groups according to their BMI (<25 kg/m2, 25-29 kg/m2, > or =30 kg/m2). Block efficacy, rate of acute complications, postoperative pain (at rest and with movement), postoperative nausea and vomiting, rate of unscheduled hospital admissions, and overall patient satisfaction were assessed. Linear and logistic multivariable analyses were used to obtain the risk-adjusted effect of BMI on these outcomes. RESULTS: Of all patients 34.8% had a BMI <25 kg/m2, 34.0% were overweight (BMI 25-29 kg/m2), and 31.3% were obese (BMI > or = 30 kg/m2). Patients with BMI > or =30 kg/m2 were 1.62 times more likely to have a failed block (P = 0.04). The unadjusted rate of acute complications was higher in obese patients (P = 0.001). However, when compared with patients with a normal BMI, postoperative pain at rest, unanticipated admissions, and overall satisfaction were similar in overweight and obese patients. CONCLUSIONS: The present investigation shows that obesity is associated with higher block failure and complication rates in surgical regional anesthesia in the ambulatory setting. Nonetheless, the rate of successful blocks and overall satisfaction remained high in patients with increased BMI. Therefore, overweight and obese patients should not be excluded from regional anesthesia procedures in the ambulatory setting.

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Published In

Anesthesiology

DOI

ISSN

0003-3022

Publication Date

January 2005

Volume

102

Issue

1

Start / End Page

181 / 187

Location

United States

Related Subject Headings

  • Treatment Failure
  • Risk Assessment
  • Prospective Studies
  • Pain Measurement
  • Obesity
  • Nerve Block
  • Middle Aged
  • Male
  • Humans
  • Female
 

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Nielsen, K. C., Guller, U., Steele, S. M., Klein, S. M., Greengrass, R. A., & Pietrobon, R. (2005). Influence of obesity on surgical regional anesthesia in the ambulatory setting: an analysis of 9,038 blocks. Anesthesiology, 102(1), 181–187. https://doi.org/10.1097/00000542-200501000-00027
Nielsen, Karen C., Ulrich Guller, Susan M. Steele, Stephen M. Klein, Roy A. Greengrass, and Ricardo Pietrobon. “Influence of obesity on surgical regional anesthesia in the ambulatory setting: an analysis of 9,038 blocks.Anesthesiology 102, no. 1 (January 2005): 181–87. https://doi.org/10.1097/00000542-200501000-00027.
Nielsen KC, Guller U, Steele SM, Klein SM, Greengrass RA, Pietrobon R. Influence of obesity on surgical regional anesthesia in the ambulatory setting: an analysis of 9,038 blocks. Anesthesiology. 2005 Jan;102(1):181–7.
Nielsen, Karen C., et al. “Influence of obesity on surgical regional anesthesia in the ambulatory setting: an analysis of 9,038 blocks.Anesthesiology, vol. 102, no. 1, Jan. 2005, pp. 181–87. Pubmed, doi:10.1097/00000542-200501000-00027.
Nielsen KC, Guller U, Steele SM, Klein SM, Greengrass RA, Pietrobon R. Influence of obesity on surgical regional anesthesia in the ambulatory setting: an analysis of 9,038 blocks. Anesthesiology. 2005 Jan;102(1):181–187.

Published In

Anesthesiology

DOI

ISSN

0003-3022

Publication Date

January 2005

Volume

102

Issue

1

Start / End Page

181 / 187

Location

United States

Related Subject Headings

  • Treatment Failure
  • Risk Assessment
  • Prospective Studies
  • Pain Measurement
  • Obesity
  • Nerve Block
  • Middle Aged
  • Male
  • Humans
  • Female