Biography
Biography: Sandeep C Mutha
Abstract
The incidence of obesity is increasing like epidemic; 65% of adults in USA are obese and approximately 5.2-37% in India. One out of five children is obese (COED - Organization of economic co-operation and development) and the rate of obese females is three times that of male. We as clinicians and anaesthesiologists have to deal with this problem more and more day by day. Obesity is a major health problem affecting almost all organ systems. Most affected systems are cardiovascular, respiratory, endocrine, airway, OSA, hepatic, renal, musculoskeletal, etc. Obese patients have higher rate of post-operative complications like myocardial infarct, neuropathy, infection, DVT, pulmonary embolism, etc. Morbidly obese are with BMI more than 40 Kg/sq.m or super-obese with BMI more than 50 Kg/sq.m are to be preoperatively prepared for better perioperative outcome. Pre-operative workup aims at controlling systemic diseases, optimizing cardio-respiratory status, stabilizing endocrinal abnormalities and improving nutrition, effort tolerance and psychological state of mind of the patient. Minimum of 10% weight reduction preoperatively with improved effort tolerance and cardiorespiratory status decreases perioperative complications and hospital stay and cost. In super obese patients pre-operative preparation may require 6-8 weeks of controlled diet, exercises and medical treatment.