A UK study on complications of anaesthesia has shown that obese patients are twice as likely to develop serious airway problems during a general anaesthetic than non-obese patients.
It has also identified that routine monitoring of breathing could reduce deaths in intensive care. The study also shows that the use of a capnograph could significantly reduce deaths and brain damage from such problems in intensive care units (ICUs); it found that absence of a capnograph contributed to 74% of deaths from these events in ICUs during the study. The report is the result of a year long prospective study by the Royal College of Anaesthetists (RCoA) and the Difficult Airway Society. In addition to the two-fold increased risk of obese patients developing serious airway problems during an anaesthetic, the study also found that patients with severe obesity were four times more likely to develop such problems. In addition, obese patients were more likely to die if they sustained airway complications in ICU. Some obese patients died from complications of general anaesthesia while undergoing procedures that could have been performed under local or regional anaesthesia. In some cases this alternative appeared not to have been considered. Dr Nick Woodall, consultant anaesthetist at the Norfolk and Norwich Hospital, and an author of the report said: “Our findings show that patients who are obese have twice the risk of major airway problems during anaesthesia, compared to non-obese patients. In the very obese this risk is even higher. The report is important for patients and anaesthetists alike. The information will enable obese patients to be better informed about the risks of anaesthesia and to give informed consent. We hope our findings will encourage anaesthetists to recognise these risks and choose anaesthetic techniques with a lower risk, such as a regional anaesthesia, where possible, and also prepare for airway difficulties when anaesthetising obese patients.”
