Anesthetic Implications of Obesity and Obstructive Sleep Apnea

The incidence of morbid obesity has tripled within the past 25 years in developed countries, with the highest rate of growth noted among people with body mass index (BMI) greater than 50. The physiologic derangements that accompany obesity affect almost every organ system leading to a vast array of comorbid conditions including obstructive sleep apnea (OSA). This review focuses on the unique perioperative management considerations that the nurse anesthetist must address when caring for these patients as well as the impact of obesity and OSA on postoperative complications and mortality rates. Current research is reviewed to highlight best practice recommendations for all phases of anesthetic management including implications for bariatric surgery and office-based practice.