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Example 2

Published online by Cambridge University Press:  05 February 2015

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Summary

Scenario

A woman of 36 presents for a laparoscopic cholecystectomy. She weighs 140 kg and has a BMI of 36. There are no other features of relevance in the history.

The patient obviously fits the definition of morbid obesity and the questioning will revolve around the definition of Body Mass Index (weight in kg divided by height in metres – squared) and the attendant problems of anaesthesia in this group of patients.

Obesity is increasing in the surgical population, and occurs in the female whose fat comprises more than 30% of her body weight, and in men when more than 25% of the body weight is fat.

Ideal body weight can be calculated by subtracting 100 (men) or 105 (women) from the height in cm.

For example: height 178: ideal weight = 178 − 100 = 78 kg

There are a number of ways of estimating obesity. The commonest is the Quetelet (BMI) index:

Body mass index (BMI)

<20 = underweight

20 − 25 = normal

25 − 30 = overweight

30 − 35 = obese

>35 = morbidly obese

For example:

Height 1.782 = 3.17

Weight = 77 kg

BMI = 77 / 3.17 = 24 − in the normal range.

For example:

Height 1.502 = 2.25

Weight = 95 kg

BMI = 95 / 2.25 = 42 − morbid obesity.

Problems of anaesthesia should be organised by systems.

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Publisher: Cambridge University Press
Print publication year: 2003

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