Airway Management in Patients With Morbid Obesity

Wadhwa, Anupama; Singh, Preet Mohinder; Sinha, Ashish

doi:10.1097/aia.0b013e318298140f

Cited by 29 publications

(17 citation statements)

References 50 publications

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“…We suggest relying upon video laryngoscopes to combat any possible difficult airway in obese patients. Those patients with occipital fat pads limiting neck extension or with Mallampati Class III or above airways require specific planning and forethought with regards to securing the airway [17]. As a general rule, we recommend adequate preoxygenation followed by head elevated laryngoscopy position (HELP) for intubation for all obese patients.…”

Section: Do Obese Patients Really Have a Difficult Airway?mentioning

confidence: 98%

“…The prevalence of obstructive sleep apnea associated with daytime sleepiness is approximately 3 to 7 % for adult men and 2 to 5 % for adult women [15] and as high as 70 % in patients with a BMI >35 kg/m 2 [16,17]. The standard for diagnosis of obstructive sleep apnea (OSA) is an overnight sleep study or polysomnography.…”

Section: How Does Excess Fat Make Anesthesia Different?mentioning

confidence: 99%

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Controversies in Perioperative Anesthetic Management of the Morbidly Obese: I Am a Surgeon, Why Should I Care?

Singh

2015

OBES SURG

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Over the last four decades, as the rates of obesity have increased, so have the challenges associated with its anesthetic management. In the present review, we discuss perioperative anesthesia management issues that are modifiable by the early involvement of the surgical team. We sum up available evidence or expert opinion on issues like patient positioning, postoperative analgesia, and the effect of continuous positive airway pressure (CPAP) ventilation on surgical anastomosis. We also address established predictors of higher perioperative risk and suggest possible management strategies and concerns of obese patients undergoing same day procedures. Finally, a generalized pharmacological model relevant to altered pharmacokinetics in these patients is presented.

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Section: Do Obese Patients Really Have a Difficult Airway?mentioning

confidence: 98%

Section: How Does Excess Fat Make Anesthesia Different?mentioning

confidence: 99%

Controversies in Perioperative Anesthetic Management of the Morbidly Obese: I Am a Surgeon, Why Should I Care?

Singh

2015

OBES SURG

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“…Patients with significant resistance (airway or chest wall) may have unacceptable leaks at pressures needed to achieve sufficient tidal volumes [45]. Morbid obesity and restrictive lung diseases are some of the examples [46]. Anatomical variations especially at the laryngopharynx can lead to difficulty in positioning.…”

Section: Choice Of Airwaymentioning

confidence: 99%

Anesthesia for Advanced Bronchoscopic Procedures: State-of-the-Art Review

Goudra

Singh

Borle

et al. 2015

Lung

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The bronchoscopic procedures have seen a remarkable increase in both numbers and complexity. Although many anesthesia providers have kept pace with the challenge, the practice is varied and frequently suboptimal. Shared airway during bronchoscopy poses unique challenges. The available reviews have tried to address this lacuna; however, these have frequently dealt with the technical aspects of bronchoscopy than anesthetic challenges. The present review provides evidence-based management insights into anesthesia for bronchoscopy-both flexible and rigid. A systematic approach toward pre-procedural evaluation and risk stratification is presented. The possible anatomical and physiological factors that can influence the outcomes are discussed. Pharmacological principles guiding sedation levels and appropriate selection of sedatives form the crux of safe anesthetic management. The newer and safer drugs that can have potential role in anesthesia for bronchoscopy in the near future are discussed. Ventilatory strategies during bronchoscopy for prevention of hypoxia and hypercarbia are emphasized.

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“…Obezite zor maske ventilasyonu ve postoperatif solunum yetmezliği ile ilişkilidir 25 . Zor hava yolu yönetimi için laringeal maske, videolaringoskop, fleksible fiberoptik bronkoskop (FFB) gibi gerekli malzemeler laringoskopi öncesi hazır bulundurulmalıdır.…”

Section: Hava Yolu Yönetimiunclassified

Obezite Hastalarında Anestezi Yönetimi

Uludağ¹,

Türktan²

2016

Arşiv Kaynak Tarama Dergisi

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Obesity has become a rapidly growing public health problem in whole world. Obesity and alterations due to obesity which include changes in metabolic, cardiovascular and pulmonary functions increase risk of perioperative mortality and morbidity. Obesity impacts anesthesia procedures significantly. Comorbid diseases such as hypertension, coronary artery disease, diabetes mellitus, and pulmonary diseases increase risk of complications during anesthesia. In this review we evaluated important factors that should be considered during planning of anesthesia for obesity surgery and other surgeries, management of intraoperative anesthesia and postoperative analgesia, and management of complications. Key words: Obesity, anesthesia management. ÖZETObezite, tüm dünyada giderek artan bir toplum sağlığı sorunu haline gelmiştir. Obezite ve obeziteye bağlı ortaya çıkan metabolik, kardiyovasküler ve pulmoner fonksiyonlar üzerinde değişiklikler, perioperatif mortalite ve morbidite riskini arttıran nedenlerdir. Obezite, anestezi uygulamalarını önemli ölçüde etkilemektedir. Vücut ağırlığının artması ile birlikte hava yolu yönetiminin zorlaşması başta olmak üzere hipertansiyon, koroner arter hastalıkları, diabetes mellitus, solunum yolu hastalıkları gibi yandaş hastalıklar anestezi riskini artırmaktadır. Bu derlemede; anestezi pratiğinde obezite cerrahisinde ve obezite dışı diğer cerrahilerde gün geçtikçe artan sayıda karşılaştığımız obez hasta popülasyonunda preoperatif anestezi planlamasında dikkat edilmesi gereken hususlar, intraoperatif anestezi yönetimi, postoperatif analjezi ve komplikasyonlar güncel bilgiler ışığında sunulmuştur. Anahtar kelimeler: Obezite, anestezi yönetimi.

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Airway Management in Patients With Morbid Obesity

Cited by 29 publications

References 50 publications

Controversies in Perioperative Anesthetic Management of the Morbidly Obese: I Am a Surgeon, Why Should I Care?

Controversies in Perioperative Anesthetic Management of the Morbidly Obese: I Am a Surgeon, Why Should I Care?

Anesthesia for Advanced Bronchoscopic Procedures: State-of-the-Art Review

Obezite Hastalarında Anestezi Yönetimi

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