Regional anesthesia and obesity.
OBJECTIVE
Worldwide, the number of overweight and obese patients has increased dramatically. As a result, anesthesiologists routinely encounter obese patients daily in their clinical practice. The use of regional anesthesia is becoming increasingly popular for these patients. When appropriate, a regional anesthetic offers advantages and should be considered in the anesthetic management plan of obese patients. The following is a review of regional anesthesia in obesity, with special consideration of the unique challenges presented to the anesthesiologist by the obese patient.


RESULTS
Recent studies report difficulty in achieving peripheral and neuraxial blockade in obese patients. For example, there is an increased incidence of failed blocks in obese patients compared with similar, normal weight patients. Despite difficulties, regional anesthesia can be used successfully in obese patients, even in the ambulatory surgery setting.


CONCLUSIONS
Successful peripheral and neuraxial blockade in obese patients requires an anesthesiologist experienced in regional techniques, and one with the knowledge of the physiologic and pharmacologic differences that are unique to the obese patient.
Ingrande
Jerry
J
Department of Anesthesia, Stanford University School of Medicine, Stanford, California 94305, USA.
Brodsky
Jay B
JB
Lemmens
Hendrikus Jm
HJ
D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000765:Anesthesia, Conduction / Q000379:methods*; D050110:Bariatric Surgery / Q000379:methods*; D006801:Humans; D009765:Obesity / Q000150:complications / Q000601:surgery; D011183:Postoperative Complications / Q000517:prevention & control*