| Dose By | Drugs |
|---|---|
| IBW / LBW | Rocuronium, vecuronium, cisatracurium, remifentanil, propofol induction |
| TBW | Succinylcholine, sugammadex, propofol maintenance, midazolam, fentanyl loading |
| PBW | Tidal volume (ARDSNet 6-8 mL/kg) |
| Scalar | Value (kg) | Formula | Source |
|---|
Sheets, S. A. (2023). Preoperative evaluation and preparation of the patient. In S. Elisha, J. S. Heiner, & J. J. Nagelhout (Eds.), Nurse anesthesia (7th ed., pp. 336-375). Elsevier.
Krogh, M. A. (2023). Obesity and anesthesia practice. In S. Elisha, J. S. Heiner, & J. J. Nagelhout (Eds.), Nurse anesthesia (7th ed., pp. 1092-1108). Elsevier.
Kim, T. K., Obara, S., & Johnson, K. B. (2025). Basic principles of pharmacology. In M. A. Gropper, N. H. Cohen, L. I. Eriksson, L. A. Fleisher, S. Johnson-Akeju, & K. Leslie (Eds.), Miller's anesthesia (10th ed., pp. 347-371). Elsevier.
Fernandez-Bustamante, A., & Bucklin, B. A. (2024). Anesthesia and obesity. In B. F. Cullen, M. C. Stock, R. Ortega, C. W. Connor, & N. Nathan (Eds.), Barash, Cullen, and Stoelting's clinical anesthesia (9th ed., pp. 3814-3876). Wolters Kluwer.
Ideal body weight is from height alone: IBW for men equals height in cm minus 100, IBW for women equals height in cm minus 105 (Lemmens, Brodsky, & Bernstein, 2006, p. 1082). Lean body weight is approximated as IBW multiplied by 1.3, since LBW runs roughly 20 to 40% above IBW in obese patients (Krogh, 2023, p. 1100).
As a rule, water soluble drugs are dosed by IBW and lipid soluble drugs by TBW (Krogh, 2023, p. 1100). Propofol is dosed by LBW for induction and TBW for maintenance, succinylcholine by TBW because pseudocholinesterase activity increases with body mass, the nondepolarizers (rocuronium, vecuronium, cisatracurium) by IBW, and remifentanil by IBW (Krogh, 2023, p. 1101).
Krogh, M. A. (2023). Obesity and anesthesia practice. In Elisha, Heiner, & Nagelhout (Eds.), Nurse anesthesia (7th ed., pp. 1092-1108). Elsevier.