Obesity affects approximately 51 million Americans, and an additional 69 million Americans are overweight. According to an article by Marciani, et al overweight and obese patients are at higher risk for complications resulting from anesthesia and surgery. The use of appropriate surgical precautions and monitoring can minimize the incidence of serious cardiovascular and pulmonary complications. The authors state that obese patients who will undergo traditional oral and maxillofacial surgery in the office setting can be safely and efficiently treated if certain measures are used in the private office. These include allowing the patient more time to arrive at and leave the office; establish ease of intravenous access during the consultation appointment; simulate the upcoming surgical procedure to establish the expected visibility and accessibility that will occur during the actual surgery; avoid surgical procedures that will contribute to airway obstruction; use monitoring equipment that is sized correctly for the patient; administer “slow and low” conscious sedation; avoid nonpatient-assisted transfer by providing recovery in the surgical suite; provide oversized wheelchair transport out of the office.
The authors note that obesity is defined as an excessively high amount of body fat or adipose tissue in relation to lean body mass. Overweight refers to increased body weight when correlated to height and compared to a standard of acceptable or desirable weights. However, being overweight is not always related to excessive fat deposits, for example, an athlete with larger muscle mass may be “overweight” according to existing charts, but not necessarily be “over fat.”
(Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontolgy, Vol. 98, No. 1, July 2004)
