Anesthetic management for super-super morbidly obese patient

Obesity leads to several changes in both airway and drug metabolism. The problems are compounded in cases of super super morbid obesity. Gastric banding surgery for weight loss was planned for a 47 year old, super-super morbidly obese female patient [164 kg and 151 cm, BMI: 72 kg/m[2] On pre-operative examination, patient had a short thick neck and grade 4 Mallampatti class. Induction of anesthesia was done in the sitting / semi-sitting position Maintenance was provided with 6% desflurane and O[2]/air mixture. Remifentanil infusion of 0.05 [xg/kg was administered during surgery. Patient had an uneventful recovery. The use of short acting drugs and appropriate monitoring provided hemodynamic stability and a fast and smooth recovery