الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Obesity is a major health problem with clearly established health implications, including an increased risk for coronary artery disease, hypertension, dyslipidemia, diabetes mellitus, gallbladder disease, degenerative joint disease, obstructive sleep apnea and socioeconomic and psychosocial impairment.
Bariatric surgery includes a variety of surgical weight loss procedures used to treat morbid obesity. The majority of bariatric procedures are now performed via laparoscopic techniques. The laparoscopic approach offers several advantages, including less postoperative pain. Over the past two decades, use of bariatric surgery to treat morbid obesity has increased dramatically.
In the obese patient, the goal of postoperative pain management is provision of comfort, early mobilization and improved respiratory function.
Complete relief of postoperative pain alone does not restore vital capacity or FRC; the single most important aspect of postoperative pulmonary care is getting the patient out of bed, preferably walking. Obese patients are at high risk for both aspiration and acute airway obstruction after tracheal extubation. Thus rapid recovery is desirable to ensure early efficient coughing and decrease the rate of postoperative respiratory complications.
Despite steady advances in anesthetic and surgical techniques over the years, post-operative complications remain one of the major drawbacks of surgery, not only for the specific patient involved but also for their surgical care team and the health care system in general.
Rarely do patients die on the operating table during the surgical procedure, but rather from the pathophysiological response to surgery and its complications.
The progressive understanding of the physiological basis of surgical injury has been the rationale underpinning the research efforts of interdisciplinary teams, incorporating surgeons and anesthesiologists to minimize the surgical stress response and thereby improve outcomes.
However, one of the immediate challenges to improve the quality of perioperative care is not to discover new knowledge, but rather to integrate what we already know into clinical practice. To this end, the concept of “fast-track surgery” was introduced.
“Fast-track” or “enhanced recovery after surgery” (ERAS) clinical pathways have been proposed to improve the quality of perioperative care with the aim of attenuating the loss of functional capacity and accelerating the recovery process.