Chapter 9 Obesity and the airway
Mark Bellamy and
Michel Struys
- • 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.
