title: Anesthetic Pharmacology and the Morbidly Obese Patient.
abstract: Anesthesiologists are increasingly being faced with treating obese patients. Physiologic and anthropometric associated with obesity-most notably increases in cardiac output, changes in tissue perfusion and increases in total body weight (TBW), lean body weight (LBW), and fat mass affect the pharmacokinetics (PK) of anesthetic agents. In addition, redundancy of airway tissue, obstructive and central sleep apnea and CO2retention affect the pharmacodynamics (PD) of anesthetics and narrow the therapeutic window of numerous anesthetic drugs. Safe and effective pharmacologic management of the obese patient requires a thorough understanding of how obesity affects the PK and PD of anesthetics.
authors.affiliation: Instructor, Department of Anesthesia, Stanford University School of Medicine, 300 Pasteur Drive Room H3580, Stanford, California 94305, (phone) 650-723-7377, (fax) 650-725-8544, jerryi@stanford.edu.
authors.forename: Jerry
authors.initials: J
authors.lastname: Ingrande
authors.forename: Hendrikus Jm
authors.initials: HJ
authors.lastname: Lemmens
keywords: cardiac output; clearance; distribution; elimination; half-life; lean body weight; obesity; peak effect; pharmacodynamics; pharmacokinetics; total body weight; volume of distribution