[Anesthesia and obesity - perioperative management of the obese patient]

The prevalence of obesity is increasing and a growing number of people with overweight present for surgery. For preoperative evaluation, the patients have to be checked for obesity-related diseases. The assurance whether the equipment can stand the increased stress needs a thorough check up. Although there is no general tendency for a higher rate of difficult intubation or increased rates of aspiration, there is a need of particular consideration. Cardiovascular function as well as tolerance to surgical stress is diminished. Pulmonary function is deterioated and impaired for at least 48 hours after surgery, which also applies to renal, hepatic function and to coagulation and glucose hemostasis. The pharmacokinetics of most anaesthetics is altered in view of initial distribution, elimination and duration of effects. Obese people without significant impairments are suitable for ambulatory surgery.