There is a significant lack of pharmacological data to guide anesthetic dosing in morbidly and super-obese patients undergoing bariatric surgery.
Clinicians should use caution dosing anesthetics in morbid obesity; leaves open the need for targeted pharmacokinetic studies.
The prevalence of obesity is increasing worldwide. For severely obese patients, bariatric surgery is the only effective option for sustained weight loss and associated health improvement. As a consequence, the number of bariatric surgical procedures being performed is growing exponentially. Systematic knowledge regarding the effect of obesity on the pharmacokinetics and pharmacodynamics of anesthetic agents is generally lacking, and data for morbidly obese (body mass index [BMI] 40-49 kg/m2)) and super-obese patients (BMI > 50 kg/m2) are almost completely non-existent. Most drug-dosing guidelines are based on results from relatively small studies in moderately obese patients. Future systematic pharmacological research is needed for improved and more rational peri-operative care of morbidly obese patients.
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Lemmens et al. (2006) studied this question.
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