Anaesthetic Management of a Case of Morbid Obesity Posted for Laparoscopic Cholecystectomy
Year: 2025
Type: article
Study design: Case Report
Abstract: Introduction: Managing anesthesia in obese patients can be challenging due to anatomical and physiological changes that may contribute to airway difculties. This case report presents a case of a morbidly obese patient undergoing laparoscopic cholecystectomy, emphasizing the anesthetic considerations and strategies used to ensure a safe and effective perioperative period. Case Report: A 30-year-old morbidly obese female (BMI: 42 kg/m²) was scheduled for elective laparoscopic cholecystectomy. Given her obesity-related challenges, a difcult airway was anticipated.On examination, vitals were stable. Abdominal examination revealed tenderness in right upper quadrant. Blood investigations were normal. Transabdominal sonography showed numerous calculi in CBD and gall bladder. A plan of administering General anaesthesia with epidural anaesthesia for the patient was made. Preoperatively optimization was done by advising NPO, antiaspiration prophylaxis. In the OT, all standard monitors were attached. Adequate preloading done. GA was chosen as the mode of anaesthesia. Preoperative Preparation included securing IV access , antiemetics and anticholinergics were administered. Difcult airway cart was kept ready. Induction & Airway Management was achieved through Sedation with midazolam, propofol, and fentanyl. Succinylcholine for rapid relaxation, followed by intubation with a 7.5mm exometallic tube was done. Maintenance & Monitoring achieved through Vecuronium for muscle relaxation, anaesthesia maintained with nitrous oxide, oxygen, and sevourane. Continuous monitoring of EtCO₂ (30-35 mmHg) and vital signs were carried out. Extubation & Recovery was achieved by Reversal with neostigmine and glycopyrrolate. Patient extubated safely after regaining protective airway reexes. Conclusion: Securing airway and anaesthetic techniques ensured a smooth perioperative course. The RAMP position was crucial in optimizing airway management. This case underscores the importance of careful preoperative planning in morbidly obese patients
Authors: Navin V Pillay, Anish Sharma, S Sanjay
Institution: KVG Medical College & Hospital
Language: English
Subfield: Anesthesiology and Pain Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4410049583