[Airway management in the morbidly obese patient]

Obesity has become a "global pandemic" in the modern world. One of the anesthetic challenges associated with obesity is securing the patients' airway. It is well known that obese patients have a higher complication rate during anesthesia as compared to patients with normal weight, but the reasons for this are controversial. Although obesity in itself does not pose a problem during anesthesia, several types of obesity, specifically the central (abdominal, visceral, android or apple-shaped) obesity, the type which is often called "inflated bear" type, cause more difficulty in maintaining open airways during the various stages of anesthesia, particularly during induction. In this review, we describe the specific reasons for difficulty in securing the airway in the obese patient population. We present the complications and the typical problems that the anesthesiologist may encounter in each stage of anesthesia and suggest ways to solve them.