Beware of:
‘Apple’ fat distribution (central obesity)
Metabolic syndrome (3 of central obesity, hyper-tension, cholesterol, sugars, lipids)
Tips:
Pre-op: STOPBANG >5 = high risk of disordered breathing/OSA
AR: Consider test dose of 50mcg fentanyl pre-induction for sensitivity for opioids
RSI: No evidence
Drug dosing: Ideally use LBW. Practically IBW + few kg. For all drugs except suxamethonium and neostigmine
Position: Reverse trendelenburg with pillow under shoulders for tragus above sternum, rather than break in the bed
Extubation: consider NPA with lidocaine
Post-op: avoid ‘tying’ to the bed e.g. with a-line, infusions