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EFFECTS OF OBESITY ON ANESTHESIA

Mansour Abdulqader Basamad , Yasir Abdulhai Siddiq , Fahad Hussain Kammas , Lujain Hamed Mutwally , Saud Khalid Alsamadani , Mohammed Ali Saleh Almesned , Tariq Mosa Khenkar , Fardus Abdulrahim Almarghalani , Lujain Abdulrahim Al Mubarak , Abdulaziz Mohammed Bamberook , Bandar Khalaf Anazi

Background: Studies have shown that obesity among adults is rapidly increasing throughout the world, Due to its associated pathophysiology, obese individuals show varied response to many medication doses, including anesthetics. The effect of obesity on anesthetics is a narrowing of the therapeutic index. Methodology: We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1985, through February 2017. The following search terms were used: anesthesia, obesity, airway management for obese patients, pharmacokinetics of anesthetics in obese patients, volume distribution Aim: In this review, we aim to study how obesity affects anesthetic medication and airway management differently. Conclusion: Anesthesia in obese adults needs careful considerations regarding changes in the PK and PD properties of many medications used in anesthesia. Physiological and anthropometric alteration, like increases in cardiac output, alterations in regional blood flow, and elevations in fat mass and lean mass affect PK properties. Additionally, respiratory pathophysiology such as the increased incidence of OSA, and fat deposition in the oropharynx and chest wall change PD characteristics of the anesthetic medications. Keywords: anesthesia, MAC, obesity, volume distribution

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