ABSTRACT
Clinically obese patients are more at risk of complications of many types, including bleeding, deep vein thrombosis, and infection. Obtaining venous access can be problematic, and because of anatomical distortion there may be diffi culty in maintaining the airway if respiratory disturbance occurs during sedation. Sleep apnoea (commonly known as Pickwick syndrome) is common in overweight patients. Due to snoring at night, the patient becomes repeatedly hypoxic, and does not sleep well. This predisposes to excessive drowsiness during the day, and exaggerated responses to the sedative effects of drugs. Increasingly, these patients have continuous positive airway pressure (CPAP) devices at home to maintain their airway and breathing at night. They may need to bring these devices into hospital with them for use in the event of post-sedation respiratory diffi culty, and recovery from sedation may have to occur in a high-dependency area.5
