The American Society of Anesthesiology has listed the following risks:
-Locating veins to deliver anesthesia and life-saving emergency medications intravenously
-Determining the right dose of medications
-Ensuring you get enough oxygen and airflow, especially if you have sleep apnea
-Adding to the time it takes to regain consciousness after surgery and your recovery time
-Increasing the risk of breathing problems with narcotics and other pain medicines
-Placing a breathing tube
I have added increased difficulty of doing regions anesthesia, especially spinal and epidural placement, especially in a morbidly obese patient.
The actions a patient can take to assure the anesthetic risks are the lowest are:
• If the surgery is not urgent, attempt to lose weight under the supervision of a medically supervised program.
• Ensure that the facility where your surgery is planned is equipped with the necessary equipment that is more likely required in the overweight or obese patient (advanced airway equipment like video laryngoscopes and fiber optic incubating flexible scopes should be readily available).
• The anesthesia provider should be experienced, and I would personally avoid a surgery theater that had only one provider, as the need for a second pair of trained hands occurs much more frequently in the overweight and obese patient.
Bottom line: Anesthesia can be made as safe as possible and be performed in patients in any weight range with a skilled physician anesthesiologist, additional anesthesia-trained providers readily available, and the proper equipment available to handle the challenges that any individual may present.
David M. Schalk, MD