Morbidly obese patients (BMI >40kg/square met) are at risk for complications in the postoperative period so should be closely monitored. Those especially with Obstructive Sleep Apnoea (OSA), may become apnoeic with a normal dose of narcotics. Post-operative pain control should be tailored to provide patient comfort without excessive sedation. Opioid dosed according to lean body mass and delivered via PCA (patient controlled analgesia) is a good option.
Non-opioid adjuvants should be considered, as these may help to reduce the dose of opioid and allowing preservation of respiratory drive. Such adjuvants include NSAIDs, ketamine, alpha 2 against dexmedetomidine & infiltration seoul of wound local Anaesthetic. If an open gastric banding had been performed, an epidural for pain control would be an appropriate strategy. Patients on CPAP devices should be encouraged to bring their devices to…
