title: Anesthetic Considerations in the Obese Parturient.
abstract: The provision of anesthesia to the morbidly obese parturient is technically challenging. The anesthesia provider anticipates difficulty with intravenous access, positioning, monitoring, and placement of neuraxial anesthesia. There is a higher incidence of hypotension in obese parturients during neuraxial anesthesia most likely due to concealed aortocaval compression as positioning these patients is difficult. Most providers will provide either epidural or combined spinal/epidural anesthesia for cesarean delivery due to the variable duration of the surgical procedure. Among obese gravidas, there is a lower risk of the development of a headache from an accidental dural puncture, due not to the body habitus, but rather to the group's higher cesarean delivery rate. It is the process of bearing down during delivery that increases the chance of the development of a headache following dural puncture.
authors.affiliation: Department of Anesthesiology and Critical Care, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Robert
authors.initials: R
authors.lastname: Gaiser
mesh_terms: D000767:Anesthesia, Epidural / Q000009:adverse effects / Q000379:methods*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects / Q000379:methods*; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000379:methods*; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology; D056128:Obesity, Abdominal; D009767:Obesity, Morbid; D011247:Pregnancy; D011248:Pregnancy Complications