Combining Volatile with Propofol and Remifentanil

This is one of the more complex questions in anaesthesia! 

Here's the actual WHO definition that doesn't use the term morbid obesity but rather obesity class 1, 2 and 3.

Obesity is frequently subdivided into categories:

• Class 1: BMI of 30 to < 35
• Class 2: BMI of 35 to < 40
• Class 3: BMI of 40 or higher. Class 3 obesity is sometimes categorized as “extreme” or “severe” obesity.

NB LISTEN TO NEXT EPISODE FOR DEEP DIVE INTO  THE EFFECT OF CARDIAC OUTPUT ON WASHOUT!!!

Millers Chapter 20 Inhaled Anesthetic Uptake, Distribution, Metabolism, and Toxicity 
Section: Recovery from Anesthesia and figures 20.4 and 20.5 show FASTER washout with LOW cardiacs output.
This is also referenced by the ex chair of first part exam at the primary LO website. 

This chapter also has good graphs to replicate for the exam.



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