• Best Pract Res Clin Anaesthesiol · Mar 2011

    Review

    Regional anaesthesia in the obese patient: lost landmarks and evolving ultrasound guidance.

    • Jay B Brodsky and Edward R Mariano.
    • Department of Anesthesia, Stanford University School of Medicine, Stanford University Medical Center, 300 Pasteur Drive, Stanford, CA 94305, USA. Jbrodsky@stanford.edu
    • Best Pract Res Clin Anaesthesiol. 2011 Mar 1; 25 (1): 61-72.

    AbstractObesity is associated with a number of anaesthetic-related risks. Regional anaesthesia offers many potential advantages for the obese surgical patient. Advantages include a reduction in systemic opioid requirements and their associated side effects, and possible avoidance of general anaesthesia in select circumstances, with a lower rate of complications. Historically, performing regional anaesthesia procedures in the obese has presented challenges due to difficulty in identifying surface landmarks and availability of appropriate equipment. Ultrasound guidance may aid the regional anaesthesia practitioner with direct visualisation of underlying anatomic structures and real-time needle direction. Further research is needed to determine optimal regional anaesthesia techniques, local anaesthetic dosage and perioperative outcomes in obese patients.

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