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Obesity and the airway 

Obesity and the airway
Obesity and the airway

Mark Bellamy

and Michel Struys

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date: 21 October 2017

• Airway management in the obese patient is challenging. • The presence of obstructive sleep apnoea and other obstructive symptoms is highly suggestive of airway difficulty. • Standard history and examination may fail to predict airway difficulty in the obese. • Airway obstruction during spontaneous breathing may result from fatty infiltration of the wall of the pharynx, with increased pharyngeal wall compliance. • Asleep intubation should only be attempted by an experienced anaesthetist with adequate assistance. It is desirable for two anaesthetists to be present. • Awake intubation may provide a safer alternative to intubation under general anaesthesia. • Similar considerations and care apply to extubation as to intubation. • Airway problems continue into the post-operative period.

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