Segmental epidural Anesthesia in an obese patient undergoing percutaneous Nephrolithotomy in prone position

The increasing incidence of obesity is a crisis in health care where these patients are increasingly being anesthetized for nonbariatric surgery. Anesthetizing an obese patient is a challenge and more so if surgery is to be done in prone position. We would like to present a patient, a 59-year-old male with body mass index of 45 (weight: 145 kg; height: 178 cm; abdominal girth: 135 cm) with a history of diabetes mellitus, hypertension, and chronic obstructive pulmonary disease since 10 years posted for a left-sided percutaneous nephrolithotomy. Successfully managed under epidural anesthesia and operated in the prone position.