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Anaesthesia in the elderly obese 

Anaesthesia in the elderly obese
Chapter:
Anaesthesia in the elderly obese
Author(s):

Samuel R. Grodofsky

and Ashish C. Sinha

DOI:
10.1093/med/9780199604999.003.0031
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date: 18 August 2019

This chapter reviews the challenges of caring for the elderly obese patient. The changes in fat deposition in the elderly are discussed before a review of the metabolic syndrome. Airway problems, the direct effect of obesity on airway management, and the increased prevalence of obstructive sleep apnoea in this group are reviewed next. Specific systematic problems are then covered starting with pulmonary effects including hypoxaemia and respiratory depression with anaesthetic and opiate analgesics. Cardiac, renal, hepatic, endocrine, and musculoskeletal risks are then reviewed in detail. The increased risk of deep vein thrombosis and the use of prophylactic heparins are detailed. The combined effects of obesity and ageing on drug handling are discussed and guidance on when dose reduction is required and whether lean body or total body weight should be used for dosage calculations are discussed.

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