Apneic oxygenation during prolonged laryngoscopy in obese patients: a randomized, controlled trial of nasal oxygen administration.
OBJECTIVE
To evaluate the influence of nasal oxygen (O(2)) administration on the duration of arterial oxygen saturation (SpO(2)) >or=95% during simulated difficult laryngoscopy in obese patients.


METHODS
Prospective, randomized, controlled trial.


METHODS
University hospital.


METHODS
30 obese men undergoing general anesthesia.


METHODS
After thorough preoxygenation, and using total intravenous anesthesia, simulated difficult laryngoscopy was performed, with half the patients receiving additional nasal O(2) during apnea.


METHODS
Duration of SpO(2) >or=95% was measured up to a maximum of 6 minutes. Lowest SpO(2) values and time to regain 100% SpO(2) (resaturation time) also were recorded.


RESULTS
Nasal O(2) administration was associated with significant prolongation of SpO(2) >or=95% time (5.29 +/- 1.02 vs. 3.49 +/- 1.33 min, mean +/- SD), a significant increase in patients with SpO(2) >or=95% apnea at 6 minutes (8 vs. one pt), and significantly higher minimum SpO(2) (94.3 +/- 4.4% vs. 87.7 +/- 9.3%). Resaturation times were no different between the groups.


CONCLUSIONS
Nasal O(2) administration is associated with significant increases in frequency and duration of SpO(2) >or=95%, and higher minimum SpO(2) during prolonged laryngoscopy in obese patients.
Ramachandran
Satya Krishna
SK
Department of Anesthesiology, University of Michigan Medical Center, Ann Arbor, MI 48109-0048, USA. rsatyak@med.umich.edu
Cosnowski
Amy
A
Shanks
Amy
A
Turner
Christopher R
CR
D001049:Apnea / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007828:Laryngoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D009765:Obesity / Q000097:blood*; D010100:Oxygen / Q000008:administration & dosage* / Q000097:blood*; D011446:Prospective Studies
D010100:Oxygen