Difficult Neuraxial Anaesthesia in Obese Patients and its Correlation with Airway Difficulty in a Tertiary Care Hospital

The proposed study will be a prospective, observational study, which will be done in the Department of Anaesthesiology and Intensive Care, at Government Medical College and Hospital, Sector 32, Chandigarh.

Patients with obesity (BMI ≥ 25 kg/m2) posted for elective orthopaedic, urological, gynaecological or general surgeries requiring central neuraxial blockade (spinal &/or epidural anaesthesia), will be studied. A relevant history will be elicited and general physical and systemic examination and routine investigations will be done.

Preoperative airway assessment with Benumof’s 11 point airway assessment will be applied.

Patient will be asked to sit on the operating table with back facing the anaesthesiologist and legs straight on the operating theatre table. Patient will be asked to flex his/her back so that intervertebral spaces can be identified. Then as per surgical requirement spinal anaesthesia ,epidural anaesthesia or combined spinal epidural anaesthesia will be provided by the anaesthesiologist.

The difficulties encountered in SAB/ epidural block will be observed and noted, and the patient will be continuously monitored during surgery. The study will be terminated as soon as central neuraxial anaesthesia is administered.

The difficulties observed in patients during administration of central neuraxial block will be noted as per gradings. This will provide the incidence of difficult central neuraxial block.

The incidence of difficult airways in obese patients of northern India will be calculated as per observations of Benumof’s difficult airway assessment tool in preoperative assessment.

It will be then observed and assessed that how many patients with difficult central neuraxial blockade have difficult airway features / predictors also. Then the correlation will be calculated.