Anesthesia for thoracic surgery in morbidly obese patients.
OBJECTIVE
This review considers the anesthetic management of obese patients undergoing thoracic surgery. Extremely or morbidly obese patients differ from patients of normal weight in several ways. Obese patients have altered anatomy and physiology, and usually have associated comorbid medical conditions that may complicate their operative course and increase their risks for postoperative complications.


RESULTS
During anesthetic induction and laryngoscopy for tracheal intubation the morbidly obese patient should be in the reverse Trendelenburg position with the head and neck elevated above the table. Placement of a double-lumen tube should be no more difficult in an obese patient than in a normal-weight patient. There are no clear advantages for any of the commonly available inhalational anesthetic agents and each can be used for general anesthesia.


CONCLUSIONS
With proper attention to their special needs, the morbidly obese patient can safely undergo thoracic surgery and one-lung ventilation.
Lohser
Jens
J
Department of Anesthesiology, Stanford University School of Medicine, Stanford, California, USA.
Kulkarni
Vivek
V
Brodsky
Jay B
JB
D000758:Anesthesia / Q000009:adverse effects; D000777:Anesthetics; D006801:Humans; D009767:Obesity, Morbid / Q000150:complications*; D010149:Postoperative Pain / Q000188:drug therapy; D011187:Posture; D011292:Premedication; D011300:Preoperative Care; D012121:Respiration, Artificial; D019616:Thoracic Surgical Procedures / Q000009:adverse effects
D000777:Anesthetics