Anaesthesia and the obese patient.

The obese patient is likely to have pre-operative impairment of cardiovascular and respiratory function. These impairments will tend to increase in the per- and post-operative period and place the patient at risk of myocardial ischaemia and hypoxaemia. The physical effects of obesity mean that all patients require endotracheal intubation during anaesthesia and this may be difficult to achieve. The difficulties in moving and positioning the patient and difficulties in gaining access for monitoring and venous cannulation add to the problems. Anaesthesia and surgery may present a considerable risk for obese patients and should not be undertaken without full understanding of the potential problems.