Obstructive Sleep Apnea Is Not a Risk Factor for Difficult Intubation in Morbidly Obese Patients

Neligan, Patrick J.; Porter, Steven B.; Max, Bryan; Malhotra, Guarav; Greenblatt, Eric P.; Ochroch, E. Andrew

doi:10.1213/ane.0b013e3181b12a0c

Cited by 124 publications

(72 citation statements)

References 34 publications

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“…In the present study, consistent with literature reports, the incidence of snoring, AH, and diabetes mellitus was higher in obese patients 10 . These fi ndings were already expected, as obesity is an independent risk factor for arterial hypertension, insulin resistance, and nocturnal airway obstruction 11 . Although obesity is a physical characteristic that is most associated with the diagnosis of obstructive sleep apnea 9 , the incidence of daytime sleepiness and apnea during sleep was similar in both groups.…”

Section: Discussionmentioning

confidence: 53%

Uso de preditores clínicos simples no diagnóstico pré-operatório de dificuldade de intubação endotraqueal em pacientes portadores de obesidade

Magalhães¹,

Marques²,

Govêia³

et al. 2013

Rev. Bras. Anestesiol.

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Background and objectives: Although the incidence of diffi cult laryngoscopy is similar in obese and non-obese patients, there are more reports of diffi cult intubation in obese individuals. Alternatives for the diagnosis and prediction of diffi cult intubation in the preoperative period may help reduce anesthetic complications in obese patients. The aim of this study was to identify predictors for the diagnosis of diffi cult airway in obese patients, correlating with the clinical methods of pre-anesthetic evaluation and polysomnography. We also compared the incidence of diffi cult facemask ventilation and diffi cult laryngoscopy between obese and non-obese patients, identifying the most prevalent predictors. Methods: Observational, prospective and comparative study, with 88 adult patients undergoing general anesthesia. In the preoperative period, we evaluated a questionnaire on the clinical predictors of the obstructive sleep apnea syndrome (OSAS) and anatomical parameters. During anesthesia, we evaluated diffi cult facemask ventilation and laryngoscopy. Descriptive statistics and correlation test were used for analysis. Results: Patients were allocated into two groups: obese group (n = 43) and non-obese group (n = 45). Physical status, prevalence of snoring, hypertension, diabetes mellitus, neck circumference, and Mallampati index were higher in the obese group. Obese patients had a higher incidence of diffi cult facemask ventilation and laryngoscopy. There was no correlation between anatomical or clinical variable and diffi cult facemask ventilation in both groups. In obese patients, the diagnosis of OSAS showed strong correlation with diffi cult laryngoscopy. Conclusions: The clinical and polysomnographic diagnosis of OSA proved useful in the preoperative diagnosis of diffi cult laryngoscopy. Obese patients are more prone to diffi cult facemask ventilation and laryngoscopy.

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Section: Discussionmentioning

confidence: 53%

Uso de preditores clínicos simples no diagnóstico pré-operatório de dificuldade de intubação endotraqueal em pacientes portadores de obesidade

Magalhães¹,

Marques²,

Govêia³

et al. 2013

Rev. Bras. Anestesiol.

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“…Clinically BMI and NC have been known to be strong predictors of OSA [15,18,22,26]. In this study, patients with OSA had greater BMI than control group.…”

Section: Discussionmentioning

confidence: 59%

What can anthropometric measurements tell us about obstructive sleep apnoea?

Yılmaz

Akcaalan

2017

Folia Morphol

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“…Reduction of the BMI allows for increased inter-incisor gap, thyromental distance, and reduction in neck circumference, whereas the Mallampati classification remains the same [11]. Some authors state that obesity, obstructive sleep apnea and neck circumference are independent factors for the occurrence of difficult endotracheal intubation [12]. Difficult intubations mostly occurred in the IV Mallampati and IV Cormack group, which was expected.…”

Section: Macocha Scorementioning

confidence: 94%

Difficult Endotracheal Intubation—Scales and Causes

Stojanović¹

2017

JPP

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Abstract:The aim of the study is to assess the possibility of intubation in each patient, the lyche to be difficult intubation, to find all the causes of the difficult intubation, to find and apply appropriate scales for difficult intubation, to estimate the frequency of difficult intubation. Endotracheal intubation is the basic reanimation procedure performed both in hospital and out-of-hospital settings. It is carried out whenever chest movements and spontaneous respiration are compromised. Respiratory arrest may occur for a variety of reasons (such as cardac arrest, coma of any origin, poisining) or direct damage to the airways, e.g. in various traumas (damages to the face, oropharynx, larynx, trachea, chest). The basic endotracheal intubation kit contains: laryngoscope, endotracheal tubes, connectors (tube and Ambu bag connectors), complete Ambu kit (face mask and bag), 20 mL syringe for cuff inflating, suction apparatus, stylete, and Magill forceps. In order to assess the successfulness of endotracheal intubation, it is necessary first to identify patients who need to be intubated. With the aim of identifying such patients, numerous screening tests and scales have been created to predict difficult intubation. The best known and most commonly used are the Mallampati and Wilson classifications as well as the LEMON airway assessment method. Nevertheless, difficult intubation accounts for 1% of cases. It usually occurs when manipulation of the laryngoscope blade is not possible in obese patients and patients with short neck, in congenital restricted mouth opening, limited neck movement as well as limited temporomandibular joint mobility; in cases of edema, fibrosis and lesions of the tongue, pharynx and larynx; when there are anatomical variations and congenital malformations of the oral cavity, pharynx, larynx, head, neck and chest.

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Obstructive Sleep Apnea Is Not a Risk Factor for Difficult Intubation in Morbidly Obese Patients

Abstract: In MO patients undergoing bariatric surgery in the "ramped position," there was no relationship between the presence and severity of OSA, BMI, or NC and difficulty of intubation or laryngoscopy grade. Only a Mallampati score of 3 or 4 or male gender predicted difficult intubation.

Cited by 124 publications

References 34 publications

Uso de preditores clínicos simples no diagnóstico pré-operatório de dificuldade de intubação endotraqueal em pacientes portadores de obesidade

Uso de preditores clínicos simples no diagnóstico pré-operatório de dificuldade de intubação endotraqueal em pacientes portadores de obesidade

What can anthropometric measurements tell us about obstructive sleep apnoea?

Difficult Endotracheal Intubation—Scales and Causes

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