Obesity is associated with obstructive sleep apnoea and obesity hypoventilation syndrome

Anaesthesia – need to avoid anything causing respiratory depression

Surgery – need to avoid anything causing constipation,

Therefore replace opioids with multimodal analgesia:

  • Simple analgesics plus
  • dexmedetodine
  • lignocaine
  • ketamine
  • If opioids necessary use short acting varieties
  • Avoid PCAs

Optimise oxygenation and oxygen reserves

  • pre-oxygenate
  • HFNP or traditional CPAP
  • apnoeic oxygenation
  • beach chair (avoid supine position)

Links:

CEACCP Bariatric Surgery

AAGBI Anaesthesia of Obese Patient

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