Eman Ahmed: Anaesthetist's role will be the toughest, says Dr Sanjay Borude

Feb 12, 2017, 15:40 IST | Vinod Kumar Menon

Noted bariatric surgeon Dr Sanjay Borude says getting dosage of anaesthesia right will be difficult in a patient of Eman's size

The truck carrying Eman Ahmed on Western Express Highway on Friday morning. Pic/Satej Shinde
The truck carrying Eman Ahmed on Western Express Highway on Friday morning. Pic/Satej Shinde

Getting an anesthetist fitness certificate will be the most challenging task for the team of doctors monitoring Eman's condition.

Speaking to mid-day noted bariatric surgeon Dr Sanjay Borude, attached to Breach Candy Hospital, said, "While the overall fitness of a patient is taken into consideration, the role of the anaesthetist team will be crucial and challenging. And, if the claim of the patient being 500 kg in weight is true, then it will be a very challenging task for the team."

"The primary task of the anesthetist will be to put the patient to sleep by providing higher doses of anaesthesia, maintaining all her parameters during the surgical procedure and getting her out of the anaesthesia effect. And the dosage of anaesthesia drugs in such cases will be five to six times than otherwise used for a regular patient," explained Dr Borude.

A senior anesthologist said on condition of anonymity, "I can sense the challenges for not only the anesthetist but also the risk that the patient is being put to. I have handled a case where the patient weighed almost 300 kg. Though the surgery was successful, it was the most challenging case I have ever dealt with."

The anaesthetist added, "Usually the dosage of the anaesthesia is calculated at 5 ml per kg of body weight and in this case, the level of dosage has to be increased heavily. This also means that the risk involved in giving higher dosage of anaesthesia is increased multi-fold, as the medicine can get accumulated in the fatty tissue and can get circulated in the blood."

As in this case the patient's body mass index (BMI) is very high, it means that the risk of anesthesia during the surgery and getting the patient out of anaesthesia will be a challenge.

Weeks for prep
"People often ask me how I have managed to operate on patients weighting above 300 kg, but the trick lies on the preparation before the surgery. Preparing a patient before the surgery is the challenge. It takes around 3-4 weeks to prepare the patient," said Dr Shashank Shah, head of the department of metabolic and bariatric and diabetic surgery at S L Raheja Hospital Mahim Mumbai and president of the Obesity Surgery Society of India.

Explaining further, Dr Shah said, "With proper preparation, the patient can lose around 5-10 per cent of the weight. But this process is about making the patient fit for surgery. Patients also need physiotherapy for the movement in their joints and limbs for better blood circulation."

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