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Perioperative management of the obese ambulatory patient

Skues, Mark A.

Current Opinion in Anesthesiology: December 2018 - Volume 31 - Issue 6 - p 693–699
doi: 10.1097/ACO.0000000000000662
AMBULATORY ANESTHESIA: Edited by Claude Meistelman

Purpose of review The prevalence of obesity continues to rise in developed countries. Increasingly, anaesthesiologists are faced with management of this cohort of patient in the ambulatory setting. This review summarizes the factors involved with such management of the obese patient as well as provision of guidance on recently accrued evidence.

Recent findings A number of reviews have emphasized the value of preoperative assessment in ambulatory management for the obese, with emphasis on diagnosis, management and outcomes of patients with obstructive sleep apnoea. Drug delivery particularly with appropriate dose schedules modified to BMI has been refined, whereas the choices of intraoperative airway management have been clarified.

Summary Perioperative care of the obese patient is a multidisciplinary team exercise involving staff, equipment and insight into the condition. On the proviso of this insight, there is no reason why ambulatory care cannot be safely provided.

Countess of Chester Hospital Foundation Trust, Chester, UK

Correspondence to Dr Mark A. Skues, BMedSci (Hons), BM, BS, FRCA, Threefield House, Mannings Lane, Hoole Bank, Chester CH2 4ET, UK. Tel: +44 7977 298264; e-mail:

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