Published on March 21, 2023
King George Military Hospital, London 1915Doctor administering anesthesia.(c) flickr.com/photos/nlmhmd/16086495137
We know that obese patients can expect longer surgery times. Just getting through the fat layers takes more time; obesity can often double the length of surgery. However, the longer the surgery proceeds, the longer the patient will need to be asleep, and the more anesthesia is necessary.
What many people don’t realize, however, and that includes many of my clients with whom I’ve had this conversation, is that the anesthesiologist has a much more difficult situation on his or her hands for surgical patients who carry a lot of extra weight vs. those patients of a healthy weight. It’s not just a matter of “turning up the dial” on an anesthesia machine to let more air out!
Obesity-related changes in anatomy have significant implications for obese patients requiring surgery and anesthesia.
Anesthesiologist using Glidescope video laryngoscope to intubate the trachea of a morbidly obese patient with challenging airway anatomy. (https://commons.wikimedia.org/wiki/File:Glidescope_02)
(c) rob3000 Fotosearch_k33784855
All of the above complications are compounded by other underlying health problems many obese patients often have, including hypertension, heart disease and diabetes.
Finally, a heavy chest and abdomen also make it more difficult for a patient to take deep breaths after surgery, not only leaving one in a groggy, weakened state for a longer period of time, but also pneumonia is more likely to develop in areas of the lung that don’t fully expand after surgery.
So . . . let’s hear it for the anesthesiologists who have to anticipate all these difficulties, prepare for them and counsel obese patients regarding potential complications.
If you’re obese and contemplating any kind of surgery, help the anesthesiologist by losing some weight . . . and that will greatly help you get through surgery with fewer complications.