Authors: Baraka, A. S.¹; Taha, S. K.²; Siddik-Sayyid, S. M.²; Kanazi, G. E.²; El-Khatib, M. F.²; Dagher, C. M.³; Chehade, J.-M. A.³; Abdallah, F. W.³; Hajj, R. E.³

Source: Anaesthesia, Volume 62, Number 8, August 2007 , pp. 769-773(5)

Publisher: Wiley-Blackwell

Abstract:

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_po₂ fell to 95% was compared between the two groups with a cut-off of 4 min. In the control group, the S_po₂ fell from 100% to 95% during the subsequent apnoea in 145 (27) s, with a significantly negative correlation (r² = 0.66, p < 0.05) between the time to desaturation to 95% and the body mass index. In the study group, the S_po₂ 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.

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1365-2044.2007.05104.x

Affiliations: 1:  Professor and Chairman 2:  Associate Professor 3:  Resident, Department of Anaesthesiology, American University of Beirut, P. O. Box 11-0236, Beirut 1107-2020, Lebanon

Publication date: 2007-08-01

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• By this author: Baraka, A. S. ;  Taha, S. K. ;  Siddik-Sayyid, S. M. ;  Kanazi, G. E. ;  El-Khatib, M. F. ;  Dagher, C. M. ;  Chehade, J.-M. A. ;  Abdallah, F. W. ;  Hajj, R. E.

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