Obesity presents a unique set of challenges for office-based anesthesia. Obese patients often have a high Mallampati class, enlarged tongue, short/thick neck, and reduced functional residual capacity (FRC). This frequently results in airway obstruction during sedation and general anesthesia. Positive pressure ventilation (PPV) as well as a jaw thrust, or chin lift combined with an oral or nasal airway, will often resolve the issue. However, if these maneuvers are unsuccessful, it can very challenging to secure the airway. A laryngeal mask airway (LMA) or intubation may be necessary although both interventions are also challenging due to anatomical factors. Anesthesia medications that may result in apnea and the use of medications that cannot be reversed should be used with extreme caution.
CITATION STYLE
Bosack, R. C. (2020). Obesity. In Office Based Anesthesia Complications: Prevention, Recognition and Management (pp. 65–72). Springer International Publishing. https://doi.org/10.1007/978-3-030-61427-0_8
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