Anesthetic management of obese asthmatic patient undergoing knee arthroplasty

Abstract

Background: Obesity and asthma are significant risk factors that increase perioperative complications, particularly related to respiratory function and airway management in orthopedic surgery. Selecting an appropriate anesthetic technique is crucial to minimize these risks and improve patient outcomes.

Method: This study employed a descriptive case-based approach in a 60-year-old female patient diagnosed with grade IV knee osteoarthritis undergoing total knee replacement under spinal anesthesia. Data were collected from preoperative assessment, intraoperative monitoring, and postoperative evaluation.

Results: The patient had a body mass index of 35 kg/m² and a history of asthma with Mallampati class III airway. Spinal anesthesia was successfully administered at the L3–L4 level without complications. Intraoperatively, the patient developed shivering and mild respiratory discomfort, which were managed with active warming and supplemental oxygen. Hemodynamic parameters remained stable throughout the procedure. Postoperative recovery was uneventful, with expected residual motor blockade and no significant complications.

Conclusion: Spinal anesthesia is a safe and effective anesthetic technique in obese patients with asthma, as it reduces airway manipulation and minimizes respiratory complications. Proper perioperative management is essential to ensure optimal outcomes in high-risk patients.