Obesity Makes Intubation More Difficult

Controversy continues about intubation difficulty in obese patients: Is obesity itself the cause, or is intubation difficult in obese patients for the same reasons that can make it difficult in nonobese patients? These investigators studied intubation characteristics of 134 lean (body-mass index [BMI] <30 kg/m²) and 129 obese (BMI ≥35 kg/m²) patients undergoing general anesthesia for routine surgery. Five difficult-airway predictors were assessed preoperatively: Mallampati Score, range of head and neck motion, width of mouth opening, presence of buck teeth, and presence of mandibular recession. Other abnormalities, such as tumors, anatomic abnormalities, and loose teeth, were also noted.

After induction of anesthesia, intubation was attempte…