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Ross Hanrahan

Drug Dose Calculation in Obesity

Suggested initial doing for commonly used anaesthetic drugs in healthy obese adults 1

Medication Dosing in Obesity

Dose by Lean Body Weight

Dose by Adjusted Body Weight
  • Propofol induction
  • Thiopentone
  • Fentanyl
  • Alfentanil
  • Morphine
  • Non-depolarising NMBs
  • Local anaesthetics
  • Paracetamol
  • Propofol infusion
  • Antibiotics
  • Neostigmine (max 5mg)
  • Sugammadex
  • Suxamethonium
  • LMWH (titrate dose with Xa levels)

Medication Dosing in Obesity

Dose by Lean Body Weight
  • Propofol induction
  • Thiopentone
  • Fentanyl
  • Alfentanil
  • Morphine
  • Non-depolarising NMBs
  • Local anaesthetics
  • Paracetamol

Dose by Adjusted Body Weight
  • Propofol infusion
  • Antibiotics
  • Neostigmine (max 5mg)
  • Sugammadex
  • Suxamethonium
  • LMWH (titrate dose with Xa levels)

Enoxaparin Dosing in Obesity

Enoxaparin Thromboprophylaxis Dosing in Obesity2

Weight

< 50kg

50 - 100kg

100 - 150kg

> 150kg

Dose

20mg daily

40mg daily

40mg BD

60mg BD

Enoxaparin Thromboprophylaxis Dosing in Obesity3

Weight

Dose

< 50kg

20mg daily

50 - 100kg

40mg daily

100 - 150kg

40mg BD

> 150kg

60mg BD

Adjusted Body Weight Calculation

References

  1. ref:2
  2. Perioperative Management of the Obese Surgical Patient - AAGBI 2015
  3. Perioperative Management of the Obese Surgical Patient - AAGBI 2015
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