Compared with usual care, supplemental oxygen delivered to the buccal space through a modified tracheal tube reduced the risk of desaturation during prolonged laryngoscopy in obese patients undergoing elective surgery.
Obese patients can desaturate quickly during emergency airway management, placing them at risk for hypoxic injury. Apneic oxygenation via nasal cannula has been shown to prolong safe apnea time in obese patients (NEJM JW Emerg Med Jul 2010 and J Clin Anesth 2010; 22:164). The effect of supplemental oxygen delivered orally has not been assessed.
In a single-center Australian study, 40 adult obese patients (body-mass index, 30–40 kg/m2) undergoing general anesthesia for elective surgery were randomized to usual care (no apneic oxygenation) or apneic oxygenation with oxygen delivered to the buccal space via a modified 3.5-mm Ring-Adair-Elwyn tube affixed to the left cheek. Patients who could not be fully preoxygenated and those with chronic lun…
Reviewing Author
DisclosuresConsultant / Advisory boardVerathon, Inc. (Scientific Advisory Board Member)
Editorial boardsScientific American Emergency Medicine; Manual of Emergency Airway Management (Editor-in-Chief)
Leadership positions in professional societiesPrograms Subcommittee Chair for the Society for Academic Emergency Medicine–Residency and Fellowship Fair
DisclosuresConsultant / Advisory boardVerathon, Inc. (Scientific Advisory Board Member)
Editorial boardsScientific American Emergency Medicine; Manual of Emergency Airway Management (Editor-in-Chief)
Leadership positions in professional societiesPrograms Subcommittee Chair for the Society for Academic Emergency Medicine–Residency and Fellowship Fair