Perioperative management of the obese ambulatory patient

The prevalence of obesity continues to rise in developed countries. Increasingly, anaesthesiologists are faced with management of this cohort of patient in the ambulatory setting. This review summarizes the factors involved with such management of the obese patient as well as provision of guidance on recently accrued evidence.

A number of reviews have emphasized the value of preoperative assessment in ambulatory management for the obese, with emphasis on diagnosis, management and outcomes of patients with obstructive sleep apnoea. Drug delivery particularly with appropriate dose schedules modified to BMI has been refined, whereas the choices of intraoperative airway management have been clarified.

Perioperative care of the obese patient is a multidisciplinary team exercise involving staff, equipment and insight into the condition. On the proviso of this insight, there is no reason why ambulatory care cannot be safely provided.