Regional anaesthesia in obese patients – un update

Background and Purpose: Obesity is a worldwide problem. The present article will summarise current opinions and evidences about the unique problems of performing regional anaesthesia in obese patients and the potential solution of these problems. The focus will be on technical and logistic difficulties attributed to the unpredicted anatomy of the obese body and appropriate adjustment of local anaesthetic dosage. Materials and Methods:We performed a comprehensive research of the literature with key words: obesity, regional anaesthesia in Medline. Results: Most reports and studies about performing regional anaesthesia in obese patients come from specific subpopulation of obstetric patients. Most reported difficulties in obese obstetric patients: complicated placement, failure to establish, insufficient duration of regional anaesthesia and longer intraoperative time. In addition obesity is associated with higher peripheral block failure (supraclavicular axillary brachial plexus). There is no clear consensus about local anaesthetic dosage adjustments in obese. Conclusions: Nowadays, we are aware of potential difficulties and possible solutions. New technologies, particularly ultrasound, and new devices offer help in solving some technical problems.