Neurosurgery in morbidly obese patients

Abstract

Obesity has significant impact on various organ systems of the body and thus needs a well-planned anaesthetic management. Obese patients with multiple co morbidities are expected to have more complications than normal individuals. Obesity may influence the risk of aneurysm formation and rupture and/or the outcome of patients who have aneurysmal SAH. Most of the neurosurgeries require different patient positions for adequate exposure of surgical site. Moreover morbidly obese patient means a huge and heavy patient who will require bigger operating table and other accessories and their implications. Confusion regarding the risks and benefits of mechanical and pharmacological prophylaxis in neurosurgical patients for DVT with risks of major and minor haemorrhage still persists. The anesthetic concerns in an obese patient undergoing neurosurgery have not been studied so far. This review aims in discussing obesity in neurosurgical patients.

Anesthesia Management in Morbidly Obese Patient Undergoing Neurosurgical Procedure: A Case Report

“…However, if conventional mask devices still can't meet higher peak inspiratory flow demands in morbidly obese patients, the application of positive end-expiratory pressure should be considered. 7,8 Excess fat affects the pharmacokinetics and Thus, to avoid overdose and adverse effects, dosage adjustment in morbidly obese patients should calculated using lean body weight instead of total body weight. 8 Opioids can be used as an additional sedative alternative.…”