Morbid Obesity
Conditions
Brief summary
The aim of this study is to compare the effect of apneic preoxygenation to conventional preoxygenation on the oxygen desaturation in morbid obese parturient performing elective caesarean section under general anesthesia.
Detailed description
Anesthetic management of the obese parturient is challenging. Both pregnancy and obesity are risk factors for a difficult airway and anesthesia-related maternal mortality. There is increased risk of difficult intubation associated with an increased difficultly in mask ventilation and increased risk of accelerated desaturation during apnea. The use of apneic oxygenation for the optimization of peri-intubation conditions is a promising means of preventing hypoxemia. Despite the recommendation of the use of nasal prongs to insufflate oxygen at flows of 5 L/min to 15 L/min during the apneic period randomized controlled trial is still not available in the morbidly obese parturient.
Interventions
DEVICEnasal prong
apneic preoxygenation group (30 patients), will receive 10 L/ min of O2 via nasal prong during preintubation apnia
Sponsors
Ain Shams University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
1. Morbid obesity parturient defined as a body mass index (BMI) above 40 kg/m2. 2. ASA physical status I-II 3. Age above 18 years. 4. Scheduled for elective caesarean section under general anesthesia.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
1. Morbid obesity parturient defined as a body mass index (BMI) above 40 kg/m2. 2. ASA physical status I-II 3. Age above 18 years. 4. Scheduled for elective caesarean section under general anesthesia.
Exclusion criteria
1. Parturient of ASA physical status III or above. 2. Suspected or known difficult airway (Mallampati class \> 2, reduced neck movement, reduced mouth opening, or Cormack-Lehane grade 4 recorded during a previous intubation procedure). 3. Any contraindication for nasal prong use, for example, tumours, fractures or trauma. 4. SpO2 ≤ 97% prior to preoxygenation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the lowest oxygen saturation recorded | during intubation procedure | percentage |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| rates of desaturation below SpO2 90% | during intubation procedure | percentage |
| rates of critical desaturation below SpO2 80% | during intubation procedure | percentage |
Countries
Egypt
Outcome results
None listed