Approximately 60 million Americans are considered obese and 9 million are severely obese. Each year approximately 26 million people undergo a procedure that requires some form of anesthesia (American Association of Nurse Anesthetists, 2006). Both regional and general anesthesia have known associated risks for individuals without current health problems. However, the numerous co-morbidities associated with obesity, i.e. hypertension, diabetes, sleep apnea, arthritis, and cancer, may pose additional anesthesia related risks to the obese individual. The purpose of this integrated literature review was to determine which anesthesia related complications occur more frequently in the obese patient and those nursing interventions that could minimize those complications.

While the overall incidence of obesity is increasing, it is disproportionately affecting women, especially African American and Hispanic women. Most of the research available investigating the effects of obesity on anesthesia related complications has been conducted with the obese parturient. Obese women are at an increased risk for failed intubation, cardiovascular compromise related to epidural usage, and a significant decrease in vital capacity related to epidural usage (Tanaka et al., 1999; von Ungern-Sternberg, et al., 2004; Cressey et al., 2001). Further, epidural placement is more technically difficult and inaccurate in the obese patient (Wasson, 2000). Finally, obese patients experience significant decreases in arterial oxygenation resulting in higher rates of infection because of decreased tissue oxygenation during surgical procedures (Kabon et. al, 2004; Yoshino et al., 2003)

While the literature is not conclusive regarding the extent and effects that obesity has on anesthesia complications, this literature review demonstrates that the obese patient is at an increased risk for anesthesia complications. Further research in this area would allow providers to educate patients more completely regarding their individual anesthesia related risks. All obese patients should be well informed regarding their specific anesthesia related risks and have the opportunity to make an informed decision regarding anesthesia. Special care, training, and understanding should be involved when planning nursing care for the obese surgical patient. With more research and a clearer understanding of the etiology and methodology of these anesthesia complications, the outcomes for the obese patient undergoing surgical procedures can be significantly improved.