surgery in obese patient

Question 1

what risks are obese pts higher at with abdominal surgery?

Answer 1

• VTE
• SSI
• wound complications (10x greater if BMI 40-49 compared to normal wt pts)

Question 2

preop work-up for obese pts

Answer 2

• difficult airway - consider anesthesia eval, OSA assessement
• if CAD RFs additionally - 12 lead EKG
• if DM - assess glucose control

Question 3

VTE ppx

Answer 3

obese pts with surgery > 45 minutes: moderate VTE risk

- LMWH or low dose unfractionated heparin or mechanical ppx

Question 4

logistic considerations

Answer 4

• wt accomodated by table

- longer veress/trocars (150 mm may be needed))

Question 5

what are most common worrisome comorbidities?

Answer 5

• OSA
• CAD
• HTN
• difficult airway