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Do Difficult Airway Techniques Predispose Obese Patients to Bronchospasm?
Polyhronis Ieropoulos1, Vassilios Tassoudis1, Nick Ntafoulis2
1Department of Anesthesiology, University Hospital of Larissa, Larissa, Greece.
Turkish Journal of Anaesthesiology and Reanimation
|August 25, 2018
Summary
Morbid obesity increases the risk of difficult intubation. However, anesthesia provider manipulations during difficult intubation did not increase bronchospasm rates in obese patients, though more research is needed.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Obesity Medicine
Background:
- Morbid obesity is independently linked to difficult intubation and bronchospasm.
- Data is lacking on whether anesthesia interventions during difficult intubation exacerbate bronchospasm in obese patients.
Purpose of the Study:
- To investigate if anesthesia provider manipulations during difficult intubation increase bronchospasm rates in morbidly obese patients.
Main Methods:
- Retrospective analysis of prospectively collected data from 50 morbidly obese patients.
- Preoperative assessment included Mallampati, Cormack-Lehane (CL) classifications, cervical spine mobility (CSM), thyromental distance (Td), and mouth opening.
- Bronchospasm detection via auscultation and peak airway pressure monitoring; data analyzed using Kruskal-Wallis H and Mann-Whitney U tests.
Main Results:
- Mallampati and CL scales significantly correlated with difficult intubation (p<0.001).
- Cervical spine mobility (CSM) did not show a significant correlation with difficult intubation (p=0.790).
- Six obese patients experienced bronchospasm unrelated to difficult intubation.
Conclusions:
- Morbidly obese patients represent a high-risk group for difficult intubation, especially with specific preoperative findings.
- Difficult intubation and associated maneuvers did not elevate bronchospasm rates in this cohort.
- Further sophisticated studies are necessary to confirm these findings due to limited data.
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