“Is it riskier for people who are overweight to go under anesthesia?”

Yes, obesity carries its own additional risk for anesthesia as compared to non-obese patients.

Yes it is more risky for overweight patients. Problems with blood pressure and airway management would be the most common issues

They do have certain increased risks with surgery and anesthesia with respect to more fit patients. Don’t worry, we know how to keep those risks limited to carry you through your procedure safely.

Don't worry. C-sections are typically done under spinal or epidural anesthesia. Overweight has its issues, but nothing your anesthesiologist is not equipped to handle.

Overweight patients have a somewhat higher risk of anesthesia and surgery. Despite this, many in the overall population are overweight and have surgery and anesthesia successfully every day. The risk of overweight is compounded with advanced age or with other diseases such as heart disease, asthma, kidney disease and others. Anesthesiologists are accustomed to taking care of these patients and will take precautions against bad outcomes.

Mostly likely, your wife will have a regional block technique for a scheduled C-section. I have been performing regional blocks for awake and comfortable sections for 34 years. In my opinion, there would be no increased anesthetic risk. If your wife required a general anesthetic (unlikely), there would be no increased risk unless her weight was extremely obese such as 375 pounds. Unless she had other medical problems, even the morbidly obese would have an extremely small risk of major problems. Modern anesthesia for C-sections is extremely safe.

Yes,

Obesity is one of the greatest risks for anesthesia. But I don’t think there is anything the husband can do to change the situation at the last minute (the time for weight reduction is long gone). There is nothing he can do, except try to provide positive sunny support for his obese wife.

Yi-Hwa Outerbridge, MD

There are some risks associated with being overweight and some of the medical conditions which might be associated with being overweight such as hypertension, diabetes, etc. However, having a C-Section is often done with an epidural block using local anesthetics. This is a very safe procedure, and avoids a number of concerns one might have with general anesthesia. Nonetheless, you should be speak with the anesthesiologist who would be present for the C Section since it sounds as though it is elective, and present your concerns so that they can review your medical history, conduct an exam, and talk to you about your anesthetic options.

In general, obesity can make our job more difficult. Most C-sections are done under either spinal or epidural anesthesia which is technically more challenging in the obese patient. However, with planned C-sections the anesthesiologist has the luxury of time compared to an emergency situation.

Obesity carries different risks and can present additional challenges to the anesthesia provider. Overweight and obese individuals have a higher risk of having Obstructive Sleep Apnea, which in itself increases the risks of anesthesia.

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