Use of Risk Assessment and Management Program System and Videolaryngoscopy for Intubation in Obese Patients: A Case Report

Abstract

Background: Controlling the airway is the anesthesiologist’s primary concern, as all sedatives and the general anesthesia technique require a patent airway for the transfer of gases between the lungs and the surrounding airway. The evaluation of the patient’s airway during the preanesthetic examination assists the anesthesiologist in planning the intubation technique to safeguard the airway. One reliable sign of airway blockage is body mass index (BMI). Case: A 62-year-old male with BMI 43 kg/m2 was posted for open umbilical hernia repair. Vital parameters were estimated. The chosen anesthesia technique was general anesthesia combined with epidural analgesia. The patient was put in the Risk Assessment and Management Program (RAMP) position using pillows to create a 25° angle that lined up the external auditory meatus and sternal notch on a level plane. Auscultation and the EtCO2 graph were used to confirm that the endotracheal tube was positioned correctly. Conclusion: A severely obese patient with limited neck extension was successfully intubated using a videolaryngoscope in the RAMP position, and the intubation went smoothly after extubation.