Anesthesia in morbidly obese patients (body mass index (BMI) greater than 40) is increasingly common.
The evaluation of the obese patient in anesthesia consultation aims to apprehend the comorbidities linked to obesity and which can interfere with perioperative management, but also to inform patients about the consequences of the intervention and means implemented to limit them.
The preoperative assessment of the obese patient is a crucial step. It must provide information on the cardiovascular and respiratory repercussions of obesity, on the existence of sleep apnea syndrome, on symptoms of gastroesophageal reflux disease (GERD), on possible mask ventilation difficulties and / or intubation.
The quality of the pre-, per- and postoperative management of the obese patient is the best guarantee of uncomplicated postoperative consequences.
This management is based on a rigorous anesthesia consultation with additional directed examinations, a judicious choice of operating technique, intraoperative monitoring specific to the field and surgery, use of anesthetic drugs with rapid elimination and effective analgesia and active prevention against thromboembolic disease.
But above all and this is a primary factor: a trained and motivated healthcare team.
Author: Dr. Didier Sirieix - Anesthesiologist-Reanimator