Considerations in treating obese patients in office-based anesthesia.

The rise in obesity prevalence worldwide has presented problems for practitioners treating patients in the ambulatory setting. As more procedures are being performed in office-based suites, anesthesiologists are being asked to provide more anesthesia services for obese patients that may compromise safety. Conventional wisdom associates a higher body-mass index (BMI) with the potential for more adverse outcomes. When combined with the limited resources available in office-based anesthesia (OBA) locations, this prompts anesthesiologists to consider placing limits on BMI. However, not every OBA location is similar, thus contributing to the difficulty in establishing consensus BMI limits. Here, we review literature addressing obesity in ambulatory surgery and point out concerns that anesthesiologists should consider when treating obese patients in an OBA setting.