Morbidly Obese Pre-eclamptic for Caesarean Section

You are the anaesthetist covering the obstetric theatre at a large regional hospital. A 30-year-old primiparous woman at 38 weeks gestation is booked for a category 2 caesarean section for a non-reassuring cardiotocograph (CTG). The patient has pre-eclampsia with a blood pressure of 160/100 mmHg while on antihypertensive treatment. She is not currently in labour. She is morbidly obese with a BMI of 58 (height 168 cm, weight 164 kg). When you review the patient, she tells you that she is needle-phobic and wants to "be asleep" for the procedure. Current medications Labetalol 40 mg q30 min IV Magnesium 1g/hour IV Methyldopa 500 mg PO QID Nifedipine IR 10 mg PO There are no known drug allergies.