Anesthesia Management in Obese Patients Undergoing Total Joint Replacement

Abstract

The multisystem changes associated with obesity present unique challenges to the orthopaedic surgeon and anesthesiologist, with implications for general anesthesia, neuraxial blockade, postoperative analgesia, and management of perioperative systemic complications. Current knowledge about the challenges associated with anesthesia in obese patients is largely derived from nonorthopaedic literature. Though the general principles of anesthesia may be applicable to the arthroplasty population, well-designed trials specifically evaluating the impact of obesity on anesthetic challenges and perioperative systemic complications in patients undergoing total joint replacement are needed. This article reviews the risks associated with anesthesia in obese patients undergoing total joint replacement, and outlines techniques to improve postoperative pain management in these patients.

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