[Anaesthesia in the extremely obese patient (author's transl)]

This paper reviews the literature on anaesthetic problems in extremely obese patients. The main concerns of the anaesthetist in these patients is pulmonary function, especially hypoxaemia. The pathogenesis of hypoxia is explained by an increased tendency to airway closure by the weight of fat, which compresses the thorax. The significance of the patient's position during and after operation is stressed. The Pickwick-Syndrome is extremely rare, even in large series of obese patients, but its diagnosis is important for therapeutic consequences. For anaesthesia in these patients neuroleptanaesthesia as well as classical inhalational procedures can be used.