Regional Anesthesia in Obese Patients

Abstract

For obese patients, it is believed that regional anesthesia has several potential advantages over general anesthesia for selective surgical procedures. Even when general anesthesia is required, the addition of a regional anesthesia technique for postoperative analgesia may decrease the requirement for supplemental systemic opioids and therefore reduce the incidence of opioid induced side-effects including respiratory depression. However, obese patients present technical challenges due to unfamiliar surface anatomy and difficulty assuming positions optimal for performance of the procedure. Surface ultrasound is emerging as a useful tool for regional anesthesia in obese patients. It can be used for pre-procedural scanning to establish needle insertion site and target location or for real-time needle guidance. Current evidence suggests that regional anesthesia can be successful and is well tolerated and has a role in the management of the obese patient.