Some anesthetic aspects of morbid obesity

Obese, morbidly obese and ultra-obese patients have multiple surgical procedures. Although they can have an acute abdomen, obstetric procedures, trauma-related procedures and many others, morbidly obese patients are most consistently cared for in the bariatric surgery operating room. The lessons from that group of patients can, could and, usually, should be applied in all patients who are morbidly obese and present for anesthetic care.

There is a paucity of recent evidence-based studies that investigate this patient population. Many recommendations in this review are based on experience of the bariatric anesthesia group at this university hospital. The current review period shows an impressive study that indicates the possibility of predicting sleep apnea fairly accurately by using a few easily answered questions instead of the 'gold standard' polysomnography. Another study showed that, in the morbidly obese, nasal ventilation might be advantageous over oronasal ventilation prior to induction.

The number of patients with obesity and morbid obesity continues to increase. Following certain guidelines will ease the management and improve outcomes of the morbidly obese patient presenting for any surgery.