Objectives
 
Chronic pain and obesity are both on the rise. Spinal cord stimulation has gained increasing popularity for spine related chronic pain. Patient’s BMI is a key factor when determining to implant a spinal cord stimulator. Conscious sedation in overweight patients can be challenging leading to airway complications and aspiration pneumonia.

 
Methods
We would like to share a case where an overweight patient was scheduled for a stage one SCS implantation with sedation using high flow nasal oxygen therapy. Advantages of this technique were the ability to provide continuous positive airway pressure,  alleviating upper airway obstruction and providing apnoeic oxygenation.


Results
The patient had a favourable outcome and went on to be implanted using a similar anaesthetic technique. It is important to highlight high-risk patients, including those who are overweight or obese. Over sedation can compromise patient's safety and subsequently lead to premature abandonment of the procedure. This highlights the need for a thorough pre-assessment to formulate a safe sedation plan specific to the patient. 
 


Conclusion
 This case demonstrates the positive impact of high flow nasal oxygen therapy when sedating overweight patients. High flow nasal oxygen therapy are widely available in most centres and should be routinely used in conscious sedation to improve patient's safety. We will present our case to share the relevance of our findings.

SAFETY PROFILE OF HIGH FLOW NASAL OXYGEN DURING SEDATION FOR SCS IMPLANTS IN PRONE PATIENTS WITH HIGH BMI