Unable to secure funding for the study.

The goal of the study is to compare deoxygenation events during anesthesia induction and mask ventilation when using standard oral pharyngeal airways or the novel distal pharyngeal airway.

This prospective RCT will study adult patients who are determined to be at high risk for deoxygenation events during induction of general anesthesia. The study will randomize patients for use of a novel airway device (distal pharyngeal airway) versus standard oral pharyngeal airway during general anesthetic induction and measure differences in severity and duration of desaturation (hypoxic) events. The premise is the new novel device will reduce hypoxic events, improving patient safety and reducing airway complications. This is critically important as hypoxic events can have significant consequences. Providing a device that minimizes hypoxic events could impact patient safety positively. Additional measurements will include reduction in unanticipated patient admissions from airway complications with DPA use.

Inclusion Criteria:

• Patient presenting for surgery at main Stanford Hospital
• Over 18 years old
• ASA Class II, III, IV
• High risk for hypoxic events during intubation based on their past medical history
• BMI >35
• Likelihood of obstructive sleep apnea utilizing the STOP-BANG questionnaire
• History of diagnosed sleep apnea
• History of difficult intubation
• Prior need for two-handed mask ventilation
• Requiring general anesthesia with endotracheal intubation for surgery

Exclusion Criteria:

• Altered mental status
• Anesthesia technique includes rapid sequence or modified rapid sequence intubation
• Poorly controlled gastroesophageal reflux