Document Detail

Management of the difficult and failed airway in obstetric anesthesia.
MedLine Citation:
PMID:  18306012     Owner:  NLM     Status:  MEDLINE    
Difficulty with airway management in obstetric patients occurs infrequently and failure to secure an airway is rare. A failed airway may result in severe physical and emotional morbidity and possibly death to the mother and baby. Additionally, the family, along with the medical and nursing staff, may face emotional and financial trauma. With the increase in the number of cesarean sections performed under regional anesthesia, the experience and training in performing endotracheal intubations in obstetric anesthesia has decreased. This article reviews the management of the difficult and failed airway in obstetric anesthesia. Underpinning this important topic is the difference between the nonpregnant and pregnant state. Obstetric anatomy and physiology, endotracheal intubation in the obstetric patient, and modifications to the difficult airway algorithms required for obstetric patients will be discussed. We emphasize that decisions regarding airway management must consider the urgency of delivery of the baby. Finally, the need for specific equipment in the obstetric difficult and failed airway is discussed. Worldwide maternal mortality reflects the health of a nation. However, one could also claim that, particularly in Western countries, maternal mortality may reflect the health of the specialty of anesthesia.
Gurinder M Vasdev; Barry A Harrison; Mark T Keegan; Christopher M Burkle
Publication Detail:
Type:  Journal Article; Review     Date:  2008-02-27
Journal Detail:
Title:  Journal of anesthesia     Volume:  22     ISSN:  0913-8668     ISO Abbreviation:  J Anesth     Publication Date:  2008  
Date Detail:
Created Date:  2008-02-28     Completed Date:  2008-05-14     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8905667     Medline TA:  J Anesth     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  38-48     Citation Subset:  IM    
Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA.
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MeSH Terms
Airway Obstruction / complications,  diagnosis,  therapy*
Anesthesia, Obstetrical*
Gastric Emptying / physiology
Heart Arrest / prevention & control
Intraoperative Complications / prevention & control*
Intubation, Intratracheal / adverse effects*,  instrumentation,  methods
Laryngoscopy / methods
Larynx / anatomy & histology
Stress, Physiological / complications,  therapy
Treatment Failure

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