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Anaesthesia Fundamental Concepts f7328544

Reason of difficult intubation in an obese patient is?

A
Difficult visualization
B
Decreased safe apnea time
C
Lower tidal volume
D
All of the above
High-Yield Explanation
Ans is 'd' i.e. All of the aboveReasons for difficult intubation in obese patientsi) Increased soft tissue mass* The increased weight & volume of soft tissue can distort the airway in a supine obese patient, making visualization of vital structures harder.* This can also make "lifting up" on the laryngoscope handle harder, as there is more weight to lift.ii) Increased pressure on diaphragm* Obese abdomens prevent normal diaphragmatic excursion, more so in supine position. This leads to lower tidal volumes in spontaneously breathing patients, faster desaturation once sedated/paralysed, and more difficult bag-valve-mask ventilation.iii) Reduced "Safe Apnoea Time"* This is the time between rendering a patient apnoeic with an anaesthetic, and the time they start to desaturate.* This happens more quickly in obese patients due to the poor mechanics of their airway (mentioned above), and their increased metabolic demands.

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