Anaesthetic management of a super morbidly obese patient for total abdominal hysterectomy: a few more lessons to learn.

BACKGROUND The prevalence of obesity is on the upward trend world-wide. This epidemic has challenging implications for anaesthetists, following the anthropometric changes associated with the disease. OBJECTIVE To highlight some of the challenges, the management and the lessons learnt during the management of this patient. METHODS This is a case report of a 52-year old super morbidly obese, diabetic, and hypertensive patient that presented for total abdominal hysterectomy. Surgery was carried out under a single-shot spinal anaesthesia with bupivacaine/fentanyl. RESULTS Under bupivacaine/fentanyl anaesthesia, she became very drowsy and had moderate to severe respiratory depression. She was arousable but had an obstructive sleep apnoea. Surgery was carried out successfully CONCLUSION A better understanding of the pathophysiology and complications that accompany obesity is needed to manage an obese patient under anaesthesia.