Background and Objectives. A 408-kg patient presented for surgical resection of a lower extremity mass.

Methods. A specially designed bed and well-planned transport were used to deliver the patient to the operating room suite. The anesthetic technique included a continuous subarachnoid catheter with tetracaine and epinephrine. Intraoperative monitoring consisted of electrocardiography, pulse oximetry, intraarterial blood pressure, and mental status examinations. Massive intraoperative hemorrhage was treated with rapid volume infusions and vasopressors.

Results. Resection of a lower extremity mass was accomplished and the patient was eventually discharged from the hospital.

Conclusions. This case report emphasizes that prior planning of all aspects of patient care is important in massively morbidly obese patients and that regional anesthesia is a valuable option in these patients.