Obesity and anaesthesia for spine and neurosurgery

Abstract

Obesity has nearly doubled in the world since 1980. Obesity is a common, serious, and costly problem. More than 10% of the world’s adult population is suffering from obesity. In 2009–2010, more than one-third of adults in the United States (35.7%) were obese. The prevalence of obesity is continuously increasing and causing problems in all aspects of healthcare including anaesthesiology. Obesity is an energy imbalance and is linked with increased morbidity and mortality and associated with a wide spectrum of medical and surgical issues. Fat-containing intracranial tumours and developmental lesions such as lipomas, dermoid and epidermoid cysts, and teratomas are common. An increased prevalence of obesity in patients undergoing craniotomy for meningiomas suggests an increased incidence of meningiomas in obese men. In this chapter, physiological changes associated with obesity, pharmacology, and the anaesthetic considerations and challenges for spine and neurosurgery are addressed.