30 year-old incarcerated male, 100kg, presents for excision and fulguration of anal condylomas. History includes: Muscular dystrophy (can raise arms above head, and no respiratory defects noted), Lipid metabolism disorder (no specifics noted, nor any additional information to be provided by patient), NIDDM (sugar 117), OSA (uses CPAP nightly).

Pre-op discussion contained several questions with only few answers. Pt denies knowledge of (or why) his medical history, except that he stopped taking Synthroid a month ago, or so, because he was told to.

Patient moves self to OR table (with minimal assistance by us). Case booked for about 30 minutes under MAC, in lithotomy position. Surgeon is unaware of how the medical history might impact our anesthetic approach. You educate the surgeon, and proceed best you can.

What would you do? I'll provide my approach after, and hoping, students chime in (first).