You are examining Mr. X (male, 117 kg/187 cm, BMI 33,5) who is about to undergo a total knee replacement surgery. He is being treated for arterial hypertension and DM, both are well compensated. What kind of premedication would you prescribe for him?
We have to treat an obese patient as if he was not on an empty stomach, therefore it is necessary to administer metoclopramide and omeprazole to eliminate GER (gastroesophageal reflux). Atropine prevents bradycardia in the beginning of anaesthesia and minimizes saliva production.
Although benzodiazepines are administered in this case, we use normal dose. Increased doses can lead to sleep apnea. We also have to prevent GER (gastroesophageal reflux) in obese patients with omeprazole and metoclopramide.
Benzodiazepines are administered in normal dose, but we have to remember the risk of GER (gastroesophageal reflux) in obese patients and prevent it omeprazole and metoclopramide. Atropine prevents bradycardia in the beginning of anaesthesia and minimizes saliva production.