Effects of Preoxygenation and Positioning of Obese Patients During Intubation

Local anesthetic systemic toxicity, due to misapplication of local anesthetic in an otherwise routine procedure, can result in deleterious effects. Although improved regional anesthesia techniques, effective test-dosing, and availability of less toxic local anesthetics have resulted in a decline in local anesthetic toxicity rates, adverse events do occur. A comprehensive review of literature was conducted and current research findings and documented case studies were systematically reviewed. The lipid sink phenomenon is the most widely accepted theoretical framework surrounding intravenous lipid emulsion treatment for local anesthetic induced cardiovascular collapse (Rothschild, Bern, Oswald, & Weinberg, 2010). Current evidence suggests that immediate infusion of lipid emulsion should be considered when clinical signs of local anesthetic toxicity manifest. By relaying information surrounding practice guidelines on local anesthetic systemic toxicity, anesthesia practitioners will have an improved understanding of local anesthetic systemic toxicity clinical diagnosis and lipid emulsion infusion as a treatment modality. Implications: When anesthesia providers pre-oxygenate their obese patients for three minutes in • • a head up position, this extends the amount of time, to safely secure the airway. !!\u27(It Keywords: Obesity, Anesthesia, pre-oxygenation, patient positioning, head-up, supin