title: Regional anaesthesia in the obese patient: lost landmarks and evolving ultrasound guidance.
abstract: Obesity is associated with a number of anaesthetic-related risks. Regional anaesthesia offers many potential advantages for the obese surgical patient. Advantages include a reduction in systemic opioid requirements and their associated side effects, and possible avoidance of general anaesthesia in select circumstances, with a lower rate of complications. Historically, performing regional anaesthesia procedures in the obese has presented challenges due to difficulty in identifying surface landmarks and availability of appropriate equipment. Ultrasound guidance may aid the regional anaesthesia practitioner with direct visualisation of underlying anatomic structures and real-time needle direction. Further research is needed to determine optimal regional anaesthesia techniques, local anaesthetic dosage and perioperative outcomes in obese patients.
authors.affiliation: Department of Anesthesia, Stanford University School of Medicine, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305, USA. Jbrodsky@stanford.edu
authors.forename: Jay B
authors.initials: JB
authors.lastname: Brodsky
authors.forename: Edward R
authors.initials: ER
authors.lastname: Mariano
mesh_terms: D000765:Anesthesia, Conduction; D000779:Anesthetics, Local / Q000008:administration & dosage; D006801:Humans; D009765:Obesity / Q000000981:diagnostic imaging* / Q000473:pathology; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000779:Anesthetics, Local