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Anaesthetists' drug dosing practices in class III obese surgical patients: A bi-national survey
Citation
Hussain, Z and Gadd, K and Curtain, C and Mirkazemi, C and Peterson, GM and Zaidi, STR, Anaesthetists' drug dosing practices in class III obese surgical patients: A bi-national survey, Anaesthesia and Intensive Care pp. 1-6. ISSN 0310-057X (2019) [Refereed Article]
Copyright Statement
Copyright The Author(s) 2019
DOI: doi:10.1177/0310057X19886596
Abstract
Class III obese (body mass index 40 kg/m2
) patients, now regularly encountered clinically, have increased perioperative
risks, including potentially from suboptimal drug dosing. However, current dosing guidelines are based on low-level
evidence and may not be widely accepted. This study aimed to investigate anaesthetists’ dosing practices for class III
obese surgical patients, explore if they had experienced an increased incidence of adverse events potentially related to
drug dosing with these patients and assess which resources they consulted for dosing advice in this population.
An electronic survey was emailed to 1000 randomly selected members of the Australian and New Zealand College
of Anaesthetists. Data were summarised and the Pearson’s χ2 test was used to compare respondents’ genders, geographic locations and seniority designations with the greater Australian and New Zealand College of Anaesthetists’
membership. There were 230 completed responses (response rate 23%). A large proportion (46%–76%) of respondents
indicated they dose class III obese patients in keeping with current recommendations; however, substantial heterogeneity in dosing practices was found. Lean body weight was the most frequently used regimen for dosing propofol,
non-depolarising muscle relaxants, sugammadex and opioids, whereas total body weight was most frequently used for
suxamethonium. Nearly 70% of respondents reported using at least one resource to assist their dosing practices in
obesity. Importantly, increased incidences of adverse events in class III obese patients related to drug dosing were
commonly experienced by respondents. Until higher-level evidence is available for dosing class III obese patients,
anaesthetists should consider current recommendations and exercise increased attention to dosing. Further clinician
education may assist in optimising dosing in this patient group.
Item Details
Item Type: | Refereed Article |
---|---|
Keywords: | Anaesthetists, adverse events, class III obesity, drug dosing, dosing resources, survey |
Research Division: | Biomedical and Clinical Sciences |
Research Group: | Pharmacology and pharmaceutical sciences |
Research Field: | Clinical pharmacology and therapeutics |
Objective Division: | Health |
Objective Group: | Clinical health |
Objective Field: | Treatment of human diseases and conditions |
UTAS Author: | Hussain, Z (Mr Zahid Hussain) |
UTAS Author: | Curtain, C (Mr Colin Curtain) |
UTAS Author: | Mirkazemi, C (Mrs Corinne Mirkazemi) |
UTAS Author: | Peterson, GM (Professor Gregory Peterson) |
UTAS Author: | Zaidi, STR (Dr Tabish Razi Zaidi) |
ID Code: | 135982 |
Year Published: | 2019 |
Deposited By: | Pharmacy |
Deposited On: | 2019-11-23 |
Last Modified: | 2020-02-27 |
Downloads: | 0 |
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