Anesthesia for Bariatric Surgery

Anesthesia for bariatric surgery in morbidly obese patients is a major challenge because of anticipated difficulties in airway management and ventilatory control, risk of perioperative respiratory complications, and continuing treatment of associated co-morbidities. Advice on anesthetic management includes thorough preoperative evaluation on cardiopulmonary functions and airway, use of ramped position and positive end-expiratory pressure (PEEP) during anesthetic induction, treatment of intraoperative hypoxemia with the combination of PEEP and recruitment maneuver, and attention to airway and respiration at emergence. This article addresses issues relevant to anesthetic management of morbidly obese patients presenting for bariatric surgery from preoperative evaluation to postoperative management.