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Obesity increases risks when having surgery

Obesity increases risks when having surgery

As well as increasing the need for surgery, obesity increases the complications associated with having anaesthesia for surgery, says specialist anaesthetist Dr Nigel Robertson, speaking today (Monday, June 9) in support of the New Zealand Medical Association’s (NZMA) call for a co-ordinated approach to tackling obesity in New Zealand.

In a major policy statement, the NZMA says obesity represents a public health crisis with major implications for New Zealanders’ health and well being, as well as the future sustainability of its health system.

Dr Robertson is the Chair of the New Zealand National Committee of the Australian and New Zealand College of Anaesthetists. He says that anaesthetists have been concerned for some time at the increasing number of obese patients on operating lists.

“Obese patients provide significant challenges for us.

“Obesity is associated with conditions such as high blood pressure, diabetes, heart disease and sleep apnoea syndrome, where breathing is significantly impaired during sleep, ultimately leading to serious heart conditions that increase risk at the time of surgery.

“Complications of obesity in the operating room can include difficulty with intravenous line insertion in very large limbs, airway and breathing management, positioning for anaesthesia and surgery, and breathing in the early recovery phase.

“Post-operative complications such as respiratory failure, pneumonia and blood clots in the legs are also more common in the obese, as well as a much higher rate of heart attack, peripheral nerve injury, wound infection and urinary tract infection.

“Already patients due to have bariatric (weight loss) surgery are asked to follow a strict diet before surgery to help alleviate the associated risks and show they are serious about weight loss.

“Maybe it is time for other patients who are overweight or obese to be asked to try to lose weight before elective surgery. Even a small weight loss is beneficial, especially if patients can also undertake light exercise such as a 30-minute walk each day before surgery.

“As the NZMA says, we all have a responsibility as doctors to engage with patients who are obese as even brief interventions can lead to at least short-term changes in behaviour and body weight. This can decrease the risks associated with their surgery and their anaesthesia, and assist their recovery.

“As anaesthetists, we support the call for a co-ordinated approach to stemming what is becoming an epidemic of obesity in this country,” Dr Robertson says.


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