As the American population grows both in number and size, anesthetists are challenged with selecting the proper dose of drugs. Some believe that doses should be based on actual body weight while others believe that calculating a dose based on lean weight or ideal weight are better options. In this study published in Anesth Analg. 2011 Jul;113(1):57-62. Epub 2010 Sep 22, Ingrande J, et al compared the induction dose of propofol in obese patients using actual weight and lean body weight.
The authors found that patients receiving propofol based on actual body weight received a larger total dose and shorter time to loss of consciousness. When given based on lean body weight, patients had similar time to loss of consciousness. The authors concluded that lean body weight appears to be the most appropriate plan for dosing propofol in the obese patient.
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Drug dosage in the obese patient is always a difficult call. It’s good to have studies to guide our practice.