ANESTHETIC MANAGEMENT EF A MASSIVELY MORBIDLY OBESE PATIENT

Background and Objectives. A 408-kg patient presented for surgical res ection of a lower extremity mass. Methods. A specially designed bed an d well-planned transport were used to deliver the patient to the opera ting room suite. The anesthetic technique included a continuous subara chnoid catheter with tetracaine and epinephrine. Intraoperative monito ring consisted of electrocardiography, pulse oximetry, intra-arterial blood pressure, and mental status examinations. Massive intraoperative hemorrhage was treated with rapid volume infusions and vasopressors. Results. Resection of a lower extremity mass was accomplished and the patient was eventually discharged from the hospital. Conclusions. This case report emphasizes that prior planning of all aspects of patient care is important in massively morbidly obese patients and that region al anesthesia is a valuable option in these patients.