International Society for the Perioperative Care of the Obese Patient

by Ashish Sinha, MD, PhD, DABA, and Anupama Wadhwa, MD

Dr. Sinha is Assistant Professor of Anesthesiology and Critical Care, and Assistant Professor of Otorhinolaryngology and Head and Neck Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania. Dr. Wadhwa is Associate Professor, University of Louisville, Site Director, Outcomes Research Consortium, Director Of Residency Curriculum, Louisville, Kentucky.

Bariatric Times. 2011;8(7):11

About the International Society for the Perioperative Care of the Obese Patient
Are you challenged when dealing with your obese patients? If you are, you might want to join this society and learn something; if you aren’t, then you might want to join this society and teach something.

During the 2010 American Society of Anesthesiologists (ASA) meeting in San Diego, California, a group of anesthesiologists came together to evaluate the relaunch of the International Society for the Perioperative Care of the Obese Patient (ISPCOP), which was established in 2004, but had been semidormant for a few years. Anesthesiologists from the United States, Canada, Mexico, Argentina, Germany, Italy, Belgium, Austria, United Kingdom, and Israel came together with founding members of ISPCOP. Prominent members in attendance included Dr. Adrian Alvarez (Argentina); Jay Brodsky (United States), an existing ISPCOP member; Dr. Jan Mulier (Belgium) founder of the European Society for the Perioperative Care of the Obese Patient (ESPCOP); and Dr. Mike Margarson of the Society of Bariatric Anesthetists (SOBA), United Kingdom.

Overwhelmingly, the opinion of all the attendees at the meeting was that the relaunch of ISPCOP would be a timely and much needed forum. This is especially true since the patients being cared for by anesthesia providers across the world are getting heavier, with commonly associated comorbidities of diabetes, obstructive sleep apnea (OSA), and hypertension. The gathering in San Diego included about 25 anesthesiologists (Figure 1). This group expressed a high degree of interest in getting organized to solve common problems facing any anesthesia, or nonanesthesia, provider who cares for patients with obesity. The group made the decision to rejuvenate the ISPCOP with new enthusiasm and a transfusion of new blood, with this set of anesthesiologists serving as the core group. The group then selected an interim board composed of 11 members from multiple countries.

Many myths persist in the anesthetic challenges patients with obesity, morbid obesity, and super obesity face. For instance, the myths of difficult airways in this population are not borne out. It has been shown to be difficult to ventilate approximately 10 percent of patients with morbid obesity. It is difficult to intubate one percent of patients, although a common misperception would estimate this percentage to be higher. An underappreciated challenge is in starting intravenous (IVs) medication. This is clearly a major test of the patients’ patience and the operator’s skill.

The purpose of this society is to promote evidence and/or expert-opinion-based care of patients with obesity, from preoperative care and testing through intraoperative care, until leaving the hospital. The ISPCOP plans to organize expert physicians into panels or groups that can provide evidence-based, or in its absence, expert-opinion-based recommendations. Subgroups would be focused on cardiac, pulmonary, regional anesthesia, or airway issues in patients with obesity.

The ISPCOP will have a half-day meeting over dinner on the Friday, October 14, 2011, just before the start of the ASA meeting, which is Ocotber 15 to 19, 2011, in Chicago, Illionois. At this meeting, the current members of ISPCOP will meet and have a scientific discussion on standards of care of obese patients and further areas of research. The group will also elect permanent officers and a board. Please check the website for further details on this half-day meeting. If you are interested in any aspect of anesthesia as it relates to obesity, and would like more information on the ASA 2011 meeting, please visit www.anesthesiology2011.org. ISPCOP will also host a half-day international obesity forum proceded by the The 15th World Congress of Anaesthesiologists (WCA), March 25 to 30, 2012, Buenos Aires, Argentina. At the ASA 2011, the ISPCOP will have an educational booth with an interactive exhibit that will allow visitors to the booth to test their knowledge of morbid obesity and its anesthetic challenges and management. There will be a prize for the winners of the quiz. Participants who receive a perfect score on the quiz will be entered in a drawing. The first- and second-prize winners will receive the book Morbid Obesity: Perioperative Management; Second Edition, by Alvarez et al and free registration to the World Congress of Anesthesiologists in Buenos Aeries, March 2012. Attendees will also have an open opportunity to join the society at the booth.

Any medical professional or professional in training who takes care of patients with obesity is invited to join this group, be it physicians, nurses, or other allied health professionals. At a relatively modest charge of $50 per year for ‘active’ physician members, $50 for nurses and other para-physician members, and $25 per year for fellows, residents, and students, joining is inexpensive and provides useful access to a forum of experts on this growing problem in medical care.

Please visit www.ispcop.org for contact information, care recommendations, protocols, and tips on common problems. There are downloadable membership forms as well as discussion boards that active members can access  from anywhere in the world. Feel free to contact any member of the interim board, or the authors directly for any additional details or questions.

Category: Past Articles, Society News