16 - Post-anesthesia care unit: Management of anesthetic and surgical complications

Summary

Post-surgical complications can range from the relatively commonplace to the potentially catastrophic. Morbidly obese (MO) patients in general and bariatric surgery patients in particular, have multiple risk factors for postoperative nausea and vomiting (PONV). Shortness of breath may be a symptom of a pulmonary embolism (PE), especially in the overweight, nonambulatory patient. The severely obese patient is at an increased risk of peri-operative peripheral neuropathy. Anastomotic leak has a significant effect on overall mortality following Roux-en-Y gastric bypass (RYGB). Anastomotic leak in the post anesthesia care unit (PACU) should occur very rarely if time is taken intra-operatively to carefully inspect all suture and staple lines. Acute abdominal hemorrhage following intestinal, and specifically bariatric surgery, can essentially be localized to either an intraluminal or intraperitoneal source. A complication that is now recognized as relatively common following prolonged surgery in MO patients is rhabdomyolysis.