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Prop Roc Tube?

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No_Pain

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For sure: roc induction + roc gtt + suggamadex. But at 500kg she would need a whopping dose. Fortunately she doesn't look like a nightmare airway with her neck length. I actually think she'll survive and I would love to do this case
 

caligas

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For sure: roc induction + roc gtt + suggamadex. But at 500kg she would need a whopping dose. Fortunately she doesn't look like a nightmare airway with her neck length. I actually think she'll survive and I would love to do this case

IMG_6806.JPG
 
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Mman

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I guess you can do anything since it is unlikely that she will survive this surgery anyway,

she won't die intraop, it'll be weeks postop when she has the PE
 

Mman

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Infection should be high on the list of her possible endings too.

In my experience they rarely close the skin on those super big ones and instead just use wound vac from the start. I think the odds of her dying from infection leading to sepsis are kinda slim.
 

Mman

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The hospital is in India though!

there are some very good hospitals in India as well as plenty of terrible ones. I have no idea what quality of hospital this is. I suppose if you do the surgery in a dump you can be almost assured of wound infection.
 
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Mman

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Would place epidural, then retrograde wire.

I'm curious what sort of max depths of LOR people have gotten on epidurals. My all time record is 15 cm on a thoracic epidural on a huge thick biker with rib fractures. I got scared when the regular Tuohy couldn't even reach spinous process and had to grab the 6 inch. Ended up working like a charm, though.
 

Consigliere

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Prop/Roc/Tube or Prop/Sux/Tube are how I do 95% of my cases. Keep it simple - put the pt. to sleep, wake them up. It's that easy. Don't complicate things. It makes ZERO difference.
 

GravelRider

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Prop/Roc/Tube or Prop/Sux/Tube are how I do 95% of my cases. Keep it simple - put the pt. to sleep, wake them up. It's that easy. Don't complicate things. It makes ZERO difference.

I think you stumbled upon the ASA's next slogan: "Anesthesia: It's so easy, even a nurse can do it."
 
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urge

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I'm surprised to hear that she is going to India. Is morbid obesity rampant in India that it is the place to go? Even more so than in Midwest US?

I hope they have a heavy duty ventilator.
 
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urge

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Don't they have pentothal in India? I would do pent sux tube.
 
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facted

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Prop/Roc/Tube or Prop/Sux/Tube are how I do 95% of my cases. Keep it simple - put the pt. to sleep, wake them up. It's that easy. Don't complicate things. It makes ZERO difference.
Do you do any regional? I 100% disagree with the above.
 

Onefellswoop87

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she won't die intraop, it'll be weeks postop when she has the PE

Why? I'm sure she'll walk and do laps around the nurses station; she's shown a commitment to her goals previously, such as obtaining the title of World's Heaviest Woman. Or she can just put the compression stockings right next to her legs. I've heard they work best if they are off but immediately next to your legs.
 

facted

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And I 100% don't care.
That's great. If your patients knew your attitude, they WOULD care. And since it sounds like you haven't done a block this decade, I'm not sure you're the best source on anesthetic technique making "zero difference".
 

Consigliere

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You're not going to be appointed to head of the Enhanced Recovery Committee at your hospital with that attitude.
And I'll lose sleep over that....ummmm.....never.
 

Consigliere

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That's great. If your patients knew your attitude, they WOULD care. And since it sounds like you haven't done a block this decade, I'm not sure you're the best source on anesthetic technique making "zero difference".
I've done more blocks then you'll do in your life, little boy.
 
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Noyac

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Consigliere, you sure have become an angry person of late. Is everything OK in your world?
 

Consigliere

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Consigliere, you sure have become an angry person of late. Is everything OK in your world?
No. Thanks for asking. Working too much, too little vacation time/time with family. That will soon change though. I appreciate you asking - that means a lot. Thanks!
 
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pjl

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Are you joking or is there an advantage to pent?

There seems to be a direct correlation between when pentathol went away and when Consigliere became crabby. I would call him getting his mojo back an advantage.


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Psai

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Ronin786

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http://www.ctvnews.ca/health/world-s-heaviest-woman-has-surgery-in-india-loses-220-pounds-1.3317919

"We are happy to inform all well-wishers that the medical team of Saifee Hospital has successfully performed the surgery on Eman Ahmed," said a statement.

"Eman successfully underwent a Laparoscopic Sleeve Gastrectomy on March 7th 2017 at Saifee Hospital. She had an uneventful surgery and anaesthesia course.

"She is now on oral fluids and accepting them well. The future course of action for the medical team working on her will be to correct all her associated medical problems, to get her fit enough to fly back to Egypt as soon as possible," it added.
 
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