Anaes SAQs · Perioperative medicine
Anaesthesia for obesity and bariatric surgery
Final-examination SAQ for anaesthesia-obesity-bariatric.
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Assessment (4). BMI class III/super-obesity range; STOP-Bang 6 implies high OSA probability; document CPAP compliance, reflux, IV access, comorbidities; calculate IBW/LBW/TBW; logistics (table limit, ramp).[1][2]
Dosing (4). Propofol induction and most opioids to LBW; suxamethonium TBW if used; rocuronium IBW/LBW; sugammadex on actual body weight; antibiotics per weight-banded protocol.[3]
Airway/ventilation (4). HELP ramp, aggressive preoxygenation, VL, aspiration precautions/RSI if indicated, second-generation SGA rescue; TV 6–8 mL/kg IBW with PEEP for pneumoperitoneum.[1]
Disposition (3). CPAP in PACU, multimodal opioid-sparing analgesia, VTE prophylaxis, HDU if criteria met (severe OSA non-compliance, super-obesity, eventful airway).[1]
References3ShowHide
- [1]Nightingale CE, Margarson MP, Shearer E, et al. Peri-operative management of the obese surgical patient 2015. Anaesthesia, 2015.PMID 25950621
- [2]Chung F, Subramanyam R, Liao P, et al. High STOP-Bang score indicates a high probability of obstructive sleep apnoea. British Journal of Anaesthesia, 2012.PMID 22401881
- [3]Ingrande J, Lemmens HJM Dose adjustment of anaesthetics in the morbidly obese. British Journal of Anaesthesia, 2010.PMID 21148651