Abstract
Special positioning is required for MO patients during induction of anesthesia since proper positioning can maximize oxygenation, improve airway management, and facilitate tracheal intubation in these patients. Extremely obese patients should never be allowed to lie flat but should be placed in the head-elevated laryngoscopy position to maximize view during direct laryngoscopy while the operating room table is tilted in the reverse Trendelenburg position to maximize the safe-apnea period and to facilitate mask ventilation.
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References
Pelosi P, Croci M, Ravagnan I et al (1997) Respiratory system mechanics in sedated, paralyzed, morbidly obese patients. J Appl Physiol 82:811–818
Biring MS, Lewis MI, Liu JI et al (1999) Pulmonary physiologic changes of morbid obesity. Am J Med Soc 318:293–297
Dixon BJ, Dixon JB, Carden JR et al (2005) Preoxygenation is more effective in the 25° head-up position than in the supine position in severely obese patients. Anesthesiology 102:1110–1115
Boyce JR, Ness T, Castroman P et al (2003) A preliminary study of the optimal anesthesia positioning for the morbidly obese patient. Obes Surg 13:4–9
Altermatt FR, Munoz HR, Delfino AE et al (2005) Pre-oxygenation in the obese patient: effects of position on tolerance to apnoea. Brit J Anaesth 95:706–709
Gander S, Frascarolo P, Suter M et al (2005) Positive end-expiratory pressure during induction of general anesthesia increases duration of nonhypoxic apnea in morbidly obese patients. Anesth Analg 100:580–584
Keller C, Brimacombe J, Kleinsasser A et al (2002) The Laryngeal Mask Airway ProSeal ™ as a temporary ventilatory device in grossly and morbidly obese patients before laryngoscope-guided tracheal intubation. Anesth Analg 94:737–740
Collins JS, Lemmens HJ, Brodsky JB et al (2004) Laryngoscopy and morbid obesity: a comparison of the “sniff” and “ramped” positions. Obes Surg 14:1171–1175
Brodsky JB, Lemmens HJ, Brock-Utne JG et al (2002) Morbid obesity and tracheal intubation. Anesth Analg 94:732–736
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Brodsky, J.B. (2013). What is the Optimal Position for Induction of Anesthesia for a Morbidly Obese Patient?. In: Leykin, Y., Brodsky, J. (eds) Controversies in the Anesthetic Management of the Obese Surgical Patient. Springer, Milano. https://doi.org/10.1007/978-88-470-2634-6_13
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DOI: https://doi.org/10.1007/978-88-470-2634-6_13
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