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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: 26 November 2020

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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