Anesthetic Management in Body Countouring Surgery

The widespread of bariatric surgery and the increase in its popularity among obese individuals resulted in the emergence of a new patient population, the Massive Weight Loss (MWL) population. It is characterized by major anatomical and physiological changes associated with the substantial postoperative weight reduction [1]. These patients, who still maintain many of the co-morbidities of obesity [2], often seek body contouring surgery. Their anesthetic management is complicated and challenging. In fact, many factors are to be addressed at the time of anesthesia, and during the postoperative period. These include pulmonary, cardiovascular and metabolic variables, which are those that increase surgical and anesthetic risks the most. To the best of our knowledge, there are no guidelines outlining the anesthetic management of patients with major weight loss following bariatric surgery [3,4]. The aim of this short report is to highlight the most salient physiological changes associated with MWL, that are of important relevance to anesthesiologists. We will finish by briefly discussing the role of regional anesthesia in this patient category.