inovmedИнновационная медицина КубаниInnovative Medicine of Kuban2541-9897Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 110.35401/2541-9897-2025-10-3-99-105inovmed-1279Research ArticleОБЗОРЫREVIEWSСпинальная анестезия у пациентов с морбидным ожирением: риски, преимущества и перспективыSpinal Anesthesia in Morbidly Obese Patients: Risks, Benefits, and Future Perspectiveshttps://orcid.org/0000-0002-6987-7519НематуллоевТ. К.NematulloevT. K.

Нематуллоев Тухтасин Комилжонович, ассистент кафедры анестезиологии, реанимации и неотложной медицины

140100, Самарканд, ул. Амира Темура 18

Tukhtasin K. Nematulloev, Assistant of the Department of Anesthesiology, Resuscitation, and Emergency Medicine

18 Amir Temur, Samarkand, 140100

tukhtasinnematulloev@gmail.comhttps://orcid.org/0000-0001-8596-1430МатлубовМ. М.MatlubovM. M.

Матлубов Мансур Муратович, д. м. н., профессор, заведующий кафедрой анестезиологии, реанимации и неотложной медицины

140100, Самарканд, ул. Амира Темура 18

Mansur M. Matlubov, Dr. Sci. (Med.), Professor, Head of the Department of Anesthesiology, Resuscitation, and Emergency Medicine

18 Amir Temur, Samarkand, 140100

Самаркандский государственный медицинский университетУзбекистанSamarkand State Medical UniversityUzbekistan20253009202510399105Copyright © Нематуллоев Т.К., Матлубов М.М., 20252025Нематуллоев Т.К., Матлубов М.М.Nematulloev T.K., Matlubov M.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.innovmedkub.ru/jour/article/view/1279

Актуальность: Морбидное ожирение сопровождается особыми физиологическими сдвигами, повышающими вероятность возникновения осложнений в пред-, интра- и постоперационном периодах. Одним из многообещающих методов снижения рисков, ассоциированных с общим наркозом, является спинальная анестезия. Однако вопросы безопасности и эффективности данного метода конкретно у пациентов с морбидным ожирением нуждаются в дополнительном изучении и научном обосновании.Цель: Оценить безопасность, эффективность и потенциальные преимущества спинальной анестезии у пациентов с морбидным ожирением, а также разработать рекомендации для снижения рисков.Материалы и методы: Проведен анализ 12 исследований (2013–2023 гг.), включавших более 1 500 пациентов с морбидным ожирением. Были проанализированы клинические результаты, частота осложнений и удовлетворенность пациентов. Использованы данные рандомизированных исследований, метаанализов и крупных когортных наблюдений.Результаты: Спинальная анестезия у пациентов с морбидным ожирением ассоциируется с меньшим количеством дыхательных осложнений (отношение шансов 0,4; 95% ДИ 0,3–0,6), сниженной потребностью в опиоидах и более коротким сроком восстановления по сравнению с общей анестезией. Однако наблюдаются технические трудности из-за анатомических особенностей, повышенный риск гипотензии (15%) и умеренно повышенная частота постпункционной головной боли (3%).Заключение: Спинальная анестезия может быть безопасным и эффективным методом для пациентов с морбидным ожирением при условии тщательного планирования и мониторинга.

Background: Morbid obesity is associated with unique physiological alterations that elevate the risk of perioperative complications. Spinal anesthesia represents a promising approach that may reduce the risks related to general anesthesia; however, its safety and efficacy in morbidly obese patients require further investigation.Objective: To evaluate the safety, efficacy, and potential benefits of spinal anesthesia in morbidly obese patients and to develop recommendations for minimizing associated risks.Materials and Methods: An analysis of 12 studies (2013–2023) involving over 1,500 morbidly obese patients was conducted. Clinical outcomes, complication rates, and patient satisfaction were evaluated. Data from randomized controlled trials, meta-analyses, and large cohort studies were utilized.Results: Spinal anesthesia in morbidly obese patients is associated with fewer respiratory complications (odds ratio 0.4; 95% CI 0.3–0.6), reduced opioid requirements, and shorter recovery time compared to general anesthesia. However, technical challenges due to anatomical characteristics, an increased risk of hypotension (15%), and a moderately higher incidence of post-dural puncture headache (3%) were observed.Conclusions: Spinal anesthesia may be a safe and effective option for morbidly obese patients when thorough planning and monitoring are implemented.

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The authors declare that there are no conflicts of interest present.