Preoperative and Perioperative Anaesthesia in Obesity

This chapter outlines the preoperative and perioperative anaesthetic management of patients with obesity undergoing musculoskeletal surgery. Patients with obesity will present for musculoskeletal surgery at increasing frequency over the next number of years. The safe management of patients with obesity presents many challenges to the multidisciplinary team (MDT), including the anaesthesiologist. The type and degree of obesity, associated comorbidities and their severity, and the type and duration of surgery all impact perioperative risk. This chapter is broken up into three sections with regards to the anaesthetic management of these patients: preoperative, intraoperative and postoperative. With robust preoperative assessment, careful perioperative planning and awareness of the potential difficulties that may arise and how to mitigate these, anaesthesiologists can risk stratify and manage patients with obesity appropriately. The aim of this chapter is to aid the anaesthesiologist in assessing, mitigating and managing risk to optimise the outcome for this important patient group.