Airway management in morbidly obese with cervical instability using awake insertion of supra glottic device and Aintree intubation catheter

Abstract

We report airway management of a morbidly obese with possible difficult mask ventilation and previous cervical fixation, posted for bariatric surgery under general anesthesia. We achieved insertion of the supra glottic device (SGD ) under conscious sedation. Endotracheal intubation was further facilitated using Aintree intubation catheter (AIC) and flexible endoscope assisted intubation via the SGD. Consent from the patient and the IEC approval was obtained prior topublication. We reviewed evidence-based anaesthetic concerns and described our airway management. Our aim was to maintaining continuous oxygenation and achieve a secure airway with minimal neck move-ment. This further guides anesthesia practitioners caring for the obese patients withanticipated difficulty in mask ventilation and additionalrisks and need for continuous oxygenation. Keywords: Obese, bariatric, difficult airway, mask ventilation, BMI, neck circumference, Aintree, Cervical instability