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Supplementation of pre‐oxygenation in morbidly obese patients using nasopharyngeal oxygen insufflation
Author(s) -
Baraka A. S.,
Taha S. K.,
SiddikSayyid S. M.,
Kanazi G. E.,
ElKhatib M. F.,
Dagher C. M.,
Chehade J.M. A.,
Abdallah F. W.,
Hajj R. E.
Publication year - 2007
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2007.05104.x
Subject(s) - medicine , oxygenation , insufflation , anesthesia , oxygenation index , body mass index , oxygen saturation , morbidly obese , surgery , oxygen , weight loss , obesity , chemistry , organic chemistry
Summary During apnoea following induction of anaesthesia, morbidly obese patients may suffer a rapid decrease in oxygen saturation. This study compares pre‐oxygenation alone with pre‐oxygenation followed by nasopharyngeal oxygen insufflation on the onset of desaturation occurring during the subsequent apnoea. A randomised controlled trial was performed in 34 morbidly obese patients undergoing gastric bypass or gastric band surgery. Seventeen patients received nasopharyngeal oxygen supplementation following pre‐oxygenation (Study group, body mass index = 41.8 (6.9) kg.m −2 ), and the other 17 patients received pre‐oxygenation alone (Control group, body mass index = 42.7 (5.4) kg.m −2 ). Time from the onset of apnoea until S p o 2 fell to 95% was compared between the two groups with a cut‐off of 4 min. In the control group, the S p o 2 fell from 100% to 95% during the subsequent apnoea in 145 (27) s, with a significantly negative correlation ( r 2 = 0.66, p < 0.05) between the time to desaturation to 95% and the body mass index. In the study group, the S p o 2 was maintained in 16 of 17 patients at 100% for 4 min when apnoea was terminated. In conclusion, nasopharyngeal oxygen insufflation following pre‐oxygenation in morbidly obese patients delays the onset of oxyhaemoglobin desaturation during the subsequent apnoea.