Retrospective assessment of the association between inhalation anesthesia and post-operative complications in morbidly obese patients undergoing bariatric surgery

Abstract

Background/Aim: Today, obesity is a rapidly growing health problem. Healthcare professionals have been encountering both obese adult and adolescent patients in the operating room more and more frequently. Morbid obesity affects all body systems, thus necessitating greater care in anesthesia management. Studies conducted in recent years have failed to find clear evidence for the most appropriate anesthesia technique with minimal effect on post-operative complications. Therefore, this study was designed to compare the effects of inhalation anesthesia and total intravenous anesthesia (TIVA) on post-operative complications in morbidly obese patients who underwent bariatric surgery. Methods: After receiving approval from the University Ethics Committee, the files of 304 patients who underwent laparoscopic gastric bypass and sleeve gastrectomy between January 2018 and December 2021 were screened. Patients with unexpectedly difficult airways, who underwent open surgery, in whom the anesthesia technique had to be changed intra-operatively for any reason, those scheduled for intensive care as decided during surgical planning, and those with liver or kidney failure were excluded from the study. A total of 278 patients were included in the study. Patients were divided into two groups according to the method of anesthesia used: (1) TIVA (Group T) and (2) inhalation anesthesia (Group I). Results: The study was performed with 278 patients of whom 213 were women, and 65 were men. Patient demographics were similar between the two groups. Comparison of the clinical characteristics of the study groups showed that the rate of admission to the intensive care unit (P=0.032), average duration of surgery (P<0.001), and complication rate (P<0.001) were significantly higher in the TIVA group than in the inhalation anesthesia group. Conclusion: Morbidly obese patients exhibit higher rates of anesthesia- and surgery-related complications because of their comorbidities. Anesthesia management and selection of anesthetics are important in these patients. Based on the literature and results of our study, inhalation agents may be preferred for morbidly obese patients because they are associated with fewer complications in this patient population. Although our study indicates that inhalation anesthesia is a safe and appropriate choice, extensive studies with a larger number of patients are needed.