Anaesthetic management of a super morbidly obese patient for total abdominal hysterectomy: a few more lessons to learn

Abstract

BACKGROUND: The prevalence of obesity is on the upward trend world-wide. This epidemic has challenging implications for anaesthetists, following the anthropometric changes associated with the disease. OBJECTIVE: To highlight some of the challenges, the management and the lessons learnt during the management of this patient. METHODS: This is a case report of a 52-year old super morbidly obese, diabetic, and hypertensive patient that presented for total abdominal hysterectomy. Surgery was carried out under a single-shot spinal anaesthesia with bupivacaine/fentanyl. RESULTS: Under bupivacaine/fentanyl anaesthesia, she became very drowsy and had moderate to severe respiratory depression. She was arousable but had an obstructive sleep apnoea. Surgery was carried out successfully CONCLUSION: A better understanding of the pathophysiology and complications that accompany obesity is needed to manage an obese patient under anaesthesia.