Anesthetic challenges in the obese patient

Obesity seems to be the modern concern to society. An increasing number of obese patients present annually to surgical wards to undergo surgical procedures. As morbid obesity affects most of the vital organs, the anesthesiologist must be prepared to deal with several challenges. These include the preoperative evaluation of the consequences of obesity, particularly on cardiac, respiratory, and metabolic systems; airway management; different pharmacokinetic and pharmacodynamic drug regimen; and perioperative management (i.e., hemodynamic, respiratory, and hyperglycemic). This paper reviews and assesses the most important anesthetic issues in managing obese patients.