[Anaesthesia in Adult Patients with Obesity]

Axel Fudickar, Berthold Bein
Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS 2019, 54 (4): 242-254
The prevalence of obesity has substantially increased worldwide during the last ten years. Hence, more anaesthetic procedures will be performed in obese patients in the future and more hospitals have to be prepared for the perioperative treatment of extremely obese patients including medical, technical and organisational issues. These include not only the management of the perioperative problems of adiposity, but also of its numerous concomitant diseases. Besides hyperlipidemia, diabetes mellitus, arterial hypertension and coronary heart disease, the obstructive sleep-apnea syndrome (OSAS) challenges the available equipment and the staff involved. Airway and breathing problems are very frequent and regional anaesthesia should be preferred. If general anaesthesia is indicated, short acting drugs like desflurane or remifentanil are recommended. Preoxygenation is improved by continuous positive airway pressure (CPAP). In this educational review, a summary of the currently known facts regarding anaesthesia in obese patients is outlined together with future perspectives. Regional anaesthesia is also recommended for postoperative pain therapy.

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