Obesity and Anesthesia
Surgery for obese patients presents special challenges for the anesthesiologist. Even simple monitoring tasks, which are essential and life-preserving for all patients, can be a challenge when the patient is significantly overweight. Veins may be harder to locate, finding an appropriate blood pressure cuff to fit the patient’s arm may be a challenge, and medication dosing can vary with heavier individuals.
A patient is considered obese if his or her body mass index is greater than 30 (click here for a BMI calculator). Illnesses associated with obesity, such as type 2 diabetes, obstructive sleep apnea, hypertension and cardiovascular disease, can have serious implications for patients requiring surgery and anesthesia.
In the operating room, obesity-related changes in anatomy make airway management challenging. Airway obstruction due to obstructive sleep apnea can result in decreased airflow and oxygen in patients receiving even minimal amounts of sedation. Placement of a breathing tube (intubation) may require special equipment and techniques. Anesthesiologists have to anticipate these difficulties, prepare for them and counsel patients regarding potential complications.
Obese patients who are scheduled for surgery should discuss their condition and their options with their physician. In addition, the patient’s anesthesiologist can explain the specific risks associated with anesthesia and obesity. Please note, patients who are considering a weight-loss program prior to surgery should discuss it with their physician first to ensure it will not interfere with the course of procedure.
The resources in this section offer obesity-related material for specific situations and suggestions for partnering with your physician to guard your safety during surgery
Other Helpful Information from the the American Society of Anesthesiologists: Obesity and Pain Management During Labor and Delivery Anesthesiology and Weight-Loss Surgery Treating Obese Patients at Ambulatory Surgery Centers Obesity and Obstructive Sleep Apnea