Airway management for cesarean delivery performed under general anesthesia

Comparison of videolaryngoscopy and direct laryngoscopy for tracheal intubation in obstetrics: a mixed-methods systematic review and meta-analysis

“…Of the initial 526 unique article citations identified by the search strategy, 35 case reports and series, seven cross-sectional studies, [56][57][58][59][60][61][62] one cohort study, 63 one crossover study, 64 and four RCTs fulfilled our inclusion criteria. [65][66][67][68] Details of the screening process are illustrated in Fig.…”

“…Further, our search uncovered some limitations of videolaryngoscopy, including the inability to fully insert a channelled videolaryngoscope (e.g., Airtraq TM ; Prodol Meditec S.A., Vizcaya, Spain that tends to be bulkier to accommodate the channel for the ETT) in the presence of restricted mouth opening, and the development of complications such as split ETT T-shaped connectors following insertion of the GlideriteÒ stylet which accompanies the GlidescopeÒ (Verathon; Bothell, Australia), palatal perforation, and postoperative hoarseness. 27,28,42 In five cross-sectional studies that examined the incidence of difficult and/or failed intubation in obstetrics, [56][57][58][59][60] only one defined difficult intubation (i.e., Cormack and Lehane grade of 3 or 4). 57 Kimura showed a difficult intubation incidence of 2.8% (eight in 286 patients), including two patients who were eventually intubated with an unspecified videolaryngoscope (after a first-attempt with direct laryngoscopy), and none of the 286 patients had a failed intubation.…”

“…Rajagopalan et al showed that the C-MACÒ (KARL STORZ; Tuttlingen, Germany) or the Glidescope were used for the first intubation attempt in ten cases where the intubation was predicted to be difficult. 59 Freedman et al reported six failed intubations in their local hospital over a 20-year period, one of which was subsequently intubated successfully with an unspecified videolaryngoscope by a second anesthesiologist. 56 Characteristics of the cohort and crossover studies and RCTs are presented in Table 2.…”

Anticipated difficult airway during obstetric general anaesthesia: narrative literature review and management recommendations.

“…We have included 136 reports, both full publications and abstracts, covering 158 cases (see also Supporting Information, Appendices S1–S6) . Case reports largely fall into two groups: those describing equipment, or a technique, for provision of general anaesthesia; or those identifying a woman who had predicted airway difficulty, who was managed with regional analgesia or anaesthesia with the aim of avoiding of general anaesthesia.…”

“…The majority of women had congenital abnormalities, but other indications were: extreme obesity ; goitre ; mediastinal mass ; HELLP syndrome ; a bitten and swollen tongue following an eclamptic fit ; and limited mouth opening . The use of sedation and topical anaesthesia techniques was highly variable.…”