Obesity is a multi-system chronic pro-inflammatory disorder with increase morbidity and mortality. Adipocytes are far more than storage vessels for lipids, they secrete a large number of physiologically active substances called adipokines that lead to inflammation, vascular, cardiac remodeling, airway inflammation and altered microvascular flow patterns. to study the anaesthetic consideration in patients undergoing bariatric surgery in the pre-operative, intraoperative and postoperative phases of surgery. All patients presenting for bariatric surgery should be evaluated pre-operatively in an anesthesia pre-surgical screening clinic. This will allow an assessment of the patients' airway as well as vascular access issues that may present due to the presence of excess adipose tissue. In addition, co-morbidities such as hypertension and diabetes must be addressed prior to surgery. For instance, in the morbidly obese patient intravenous access may be difficult at best. These patients may benefit from a PIC line, or a central line, inserted on the day of surgery.