Obesity is a condition of excessive accumulation of body fat to a level that is harmful to health. The prevalence of obesity is increasing worldwide at an alarming rate. Therefore it is essential to know the perioperative management and specific considerations in this population. The majority of obese patients who undergo surgical procedures have few additional pathology, so their perioperative risk is similar to eutrophic patients. Obesity Surgery Mortality Risk Stratification Score OS-MRS is a validated scale for assessing the risk of perioperative mortality in these patients. It is essential to look for the presence of respiratory sleep disorders in these patients, and for this purpose, the STOP-BANG questionnaire is the most valid today. During anesthetic induction it is recommended to place the patient in the "ramp" position as it significantly improves the visualization of the glottis during laryngoscopy. Also, this position optimizes the oxygenation and ventilatory mechanics of these patients, increasing the time of safe apnea. Regarding airway management, orotracheal intubation with controlled ventilation is the technique of choice in this population. Anesthetic drug doses should be calculated based on adjusted weight or lean weight, depending on the type of drug chosen. Finally, complete and frequent postoperative monitoring is recommended in the recovery unit, transferring these patients to their room only when they meet the criteria included in the White and Song scale.
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