Continuous Positive Airway Pressure via the Boussignac System Immediately after Extubation Improves Lung Function in Morbidly Obese Patients with Obstructive Sleep Apnea Undergoing Laparoscopic Bariatric Surgery

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Abstract
MORBIDLY obese (MO) patients are at elevated risk for perioperative pulmonary complications. These include increased atelectasis, due to loss of functional residual capacity (FRC), anesthesia, and surgery and airway obstruction consequent of obstructive sleep apnea-hypopnea syndrome, anesthesia, and opioid analgesia.1–3 A variety of techniques have been applied to minimize the development of perioperative atelectasis, including reverse Trendelenberg positioning, intraoperative positive end expiratory pressure (PEEP), and continuous positive airway pressure (CPAP) during induction of anesthesia. However, the period immediately after extubation is a potentially hazardous time due to the risks of airway obstruction, narcosis, residual anesthesia, and residual neuromuscular blockade.