Anaesthesia in obese patients
You are examining Mr. X (male, 117 kg/187 cm, BMI 33,5) who is about to undergo a total knee replacement surgery. He is being treated for arterial hypertension and DM, both are well compensated. What kind of premedication would you prescribe for him?
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We administer the usual premedication (hypnogen in the evening before surgery, midazolam in the morning) in increased dose due to patient’s weight.
20 mg of omeprazole and 10 mg of hypnogen perorally in the evening before surgery. 20 mg of omeprazole combined with 10 mg of metoclopramide, 7,5 mg of midazolam perorally and 0,5 mg of atropine IM.
We administer the usual premedication (hypnogen in the evening before surgery, midazolam in the morning). It is not necessary to increase the dose for obese patients.
187
cm
117
kg
man
RR
12 /min
HR
75 /min
SpO2
98 %
BP
135/80 (98) mmHg
EKG
rythm: sinus
action: regular
frequency: 75 bpm
Glycaemia
Gly
5,8  mmol/L
Complete blood count
HGB
150  g/L
HTC
0,42
ERC
5  x1012/L
LEU
6  x109/L
PLT
320  x109/L
Biochemical analysis
Na
142  mmol/L
K
4,6  mmol/L
Cl
103  mmol/L
Mg
1,1  mmol/L
Ca
2,4  mmol/L
P
0,8  mmol/L
Glycaemia
Take a sample
Complete blood count
Take a sample
Biochemical analysis
Take a sample