What is the best way to induce general anesthesia in obese patients?

Abstract

Induction of anesthesia in obese patients requires an appreciation of their limited oxygen reserves, increased oxygen demands, and exquisite susceptibility to narcotics and sedative hypnotics. The relatively short, safe apneic period can be extended by using evidence-based pre-oxygenation strategies. A basic understanding of pharmacodynamics and pharmacokinetics in the obese patient facilitates tracheal intubation and prevents hemodynamic instability secondary to drug overdose. In short, induction of general anesthesia in the obese patient necessitates planning as complications are less forgiving in this patient population.