Obese Patient with Proximal Humerus Fracture and LA Toxicity

A 47-year-old man is on your list today for an open reduction and internal fixation of a right proximal humerus fracture. His injury was sustained in a motorbike accident three days ago. Following his accident he was assessed in the emergency department and then discharged home. Medications: - Metformin 1g bd - Atorvastatin 40mg daily - Perindopril 8mg daily - Paracetamol 1g q4h PRN (last three days) - Oxycodone 10mg q4h PRN (last three days) Weight 146kg, height 180cm, body mass index 45 kg/m2 Heart rate 78 beats per minute Blood pressure 148/86 mmHg SpO2 96% on air Respiratory rate 16 breaths per minute On initial inspection he has a full beard, a graze on the right side of his face, and bruising on the right side of his chest and right hip. His right arm is in a collar and cuff sling.