Airway Scope vs GlideScope for Intubation in Obese Patients

This is a randomized controlled trial of two video laryngoscope devices when used in patients with high (≥40) Body Mass Index (BMI): Airway Scope (Nihon Kohden) and GlideScope (Verathon Inc.). The study compares several outcomes as proxies for ease of intubation including time to complete intubation, number of attempts needed, minimum peripheral oxygen saturation (SpO2) during intubation, and number of episodes of SpO2 falling below 90% before intubation is completed. The patient population is consenting adult patients with BMI ≥40, who are already scheduled for general anesthesia. Intubations will be performed by attending anesthesiologists or anesthesiology residents. Obesity is a known risk factor for difficult intubation due to anatomical changes caused by increased soft tissue around the face and neck. Obese patients' blood oxygen level can rapidly fall during intubation because these patients often have reduced functional residual capacity, and the acuity of any complications may also be increased because these patients also often have additional comorbidities.

Inclusion criteria

• Adult (age ≥18 years)
• Body Mass Index (BMI) ≥40
• Scheduled for surgery with general anesthesia

Exclusion criteria

• Pregnancy
• Congenital facial or airway anomalies
• History of major neck surgery or tracheostomy
• History of any lung diseases/conditions such as Chronic Obstructive Pulmonary Disease, lung resection, or lung cancer
• History of cardiac failure or myocardial infarction
• Prisoners