Procedural sedation in the morbidly obese: implications, complications, and management

Before providing sedation to patients with morbid obesity, a focused history and physical examination should be performed. Routine monitoring during and post-procedure should include pulse rate, blood pressure, oxygen saturation, and capnography to identify early problems and avoid further complications. Drug dosing should be titrated to the desired effect without compromising patients’ safety. Providers should have a thorough understanding of the pharmacokinetic and pharmacodynamics of drugs administered to patients with obesity and should have the necessary skills to diagnose and troubleshoot potential pulmonary and cardiac complications. Patients with morbid obesity should be monitored for clinical evidence of hypoxemia and hypercarbia before discharge. © 2020 Lippincott Williams and Wilkins. All rights reserved.