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You are asked to anaesthetize a 44-year-old patient for gastric bypass surgery. She weighs 136 kg (a BMI of 47 kg m–2), and is on medication for hypertension (150/90 mmHg), angina and arthritis. The patient reports that her exercise tolerance is limited and she is unable to walk up a flight of stairs, which she states is, in part, due to knee pain. The surgeons believe that the operation will take about 4 hours. What method of blood pressure measurement will you select intra-operatively and why? The surgeons require the operating table to be tilted head up; will this affect the accuracy of the blood pressure reading if an invasive method is used?
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