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A Conical Cuff and Other Stuff

Blood Pressure Monitoring in the Obese is Tough

Wanderer, Jonathan P., MD, MPhil; Nathan, Naveen, MD

doi: 10.1213/ANE.0000000000004041
Infographics: Infographic

Vanderbilt University School of Medicine (

Northwestern University Feinberg School of Medicine (

Published ahead of print 26 December 2018.

The Infographic is composed by Jonathan P. Wanderer, MD, MPhil, Vanderbilt University School of Medicine (, and Naveen Nathan, MD, Northwestern University Feinberg School of Medicine ( Illustration by Naveen Nathan, MD.

The authors declare no conflicts of interest.



The prevalence of obesity is increasing worldwide, and the number of perioperative patients who have the associated comorbidities of hypertension, obstructive sleep apnea, and diabetes mellitus has been on the rise. A key part of providing safe anesthetic care is the ability to accurately measure blood pressure. In addition to comorbidity burden, obesity can create multiple challenges for effectively measuring blood pressure. In this infographic, we provide a review of the difficulties that obesity provides for blood pressure measurement and describe several types of devices that may be more effective in this patient population than conventional noninvasive blood pressure cuffs.

BP indicates blood pressure; OR, operating room

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1. Eley VA, Christensen R, Guy L, Dodd B. Perioperative blood pressure monitoring in patients with obesity. Anesth Analg. 2019;128:484–491.
© 2019 International Anesthesia Research Society