Gestion des voies aériennes en obstétrique

Boutonnet, Mathieu; Faitot, Valentina; Keïta, H.

doi:10.1016/j.annfar.2011.03.024

Cited by 32 publications

(9 citation statements)

References 95 publications

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“…[ 20 ] showed a similar incidence of DVL in obstetrics (8.7%). In another recent literature by Boutonnet et al .,[ 6 ] performed to evaluate the anesthetic practices in obstetrics, the incidence of difficult intubation was found to be 3.3%. Another study by Merah et al .…”

Section: Discussionmentioning

confidence: 99%

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The predictive value of the ratio of neck circumference to thyromental distance in comparison with four predictive tests for difficult laryngoscopy in obstetric patients scheduled for caesarean delivery

et al. 2014

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Background:Preoperative assessment of anatomical landmarks andclinical factors help detect potentially difficult laryngoscopies. The aim of the present study was to compare the ability to predict difficult visualization of the larynx from thefollowing preoperative airway predictive indices, in isolation and combination: Neck circumference to thyromental distance (NC/TMD), neck circumference (NC), modified Mallampatitest (MMT), the ratio of height to thyromental distance (RHTMD), and the upper-lip-bite test (ULBT).Materials and Methods:We collected data on657 consecutive patients scheduled for elective caesarean delivery under general anesthesia requiring endotracheal intubation and then evaluated all five factors before caesarean. An experienced anesthesiologist, not informed of the recorded preoperative airway evaluation, performed the laryngoscopy and grading (as per Cormack and Lehane's classification). Sensitivity, specificity, and positive and negative predictive values for each airway predictor in isolation and in combination were determined.Results:Difficult laryngoscopy (Grade 3 or 4) occurred in 53 (8.06%) patients. There were significant differences in thyromental distance (TMD), RHTMD, NC, and NC/TMD between difficult visualization of larynx and easy visualization of larynx patients (P < 0.05). The main end-point area under curve (AUC) of the receiver-operating characteristic (ROC) was lower for MMT (AUC = 0.497; 95% Confidence Interval = CI,0.045-0.536) and ULBT (AUC = 0.500, 95% CI, 0.461-0.539) compared to RHTMD, NC, TMD, and NC/TMD score ([AUC = 0.627, 95% CI, 0.589-0.664], [AUC = 0.691; 95% CI, 0.654-0.726], [AUC = 0.606; 95% CI, 0.567-0.643], [AUC = 0.689;95% CI, 0.625-0.724], respectively), and the differences of six ROC curves were statistically significant (P < 0.05).Conclusion:The NC/TM Discomparable with NC, RHTMD, and ULBT for the prediction of difficult laryngoscopy in caes are an delivery.

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Section: Discussionmentioning

confidence: 99%

“…[ 2 ] The incidence of difficult larygoscopy or endothracheal intubation varies from 1.5% to 13% in patients undergoing general anesthesia. [ 2 3 4 5 6 7 ]…”

Section: Introductionmentioning

confidence: 99%

The predictive value of the ratio of neck circumference to thyromental distance in comparison with four predictive tests for difficult laryngoscopy in obstetric patients scheduled for caesarean delivery

et al. 2014

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“…Une intubation rapide est assurée avec la séquence succinylcholine 1 mg/kg intraveineuse (poids réel de fin de grossesse) plus hypnotiques combinés à la manoeuvre de Sellick après une préoxygénation soigneuse en raison des capacités réduites en oxygène [35,36]. Le diamètre de la sonde trachéale est le plus souvent < 7,5, la laryngoscopie peut être compliquée par la fragilité vasculaire des muqueuses en fin de grossesse.…”

Section: Intubationunclassified

Anesthésie pour césarienne

Chassard

Bouvet

2015

Anesthésie & Réanimation

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“…Airway management becomes increasingly demanding when gestation progresses because of increased body weight, short neck, enlarged breasts, nasopharyngeal edema and capillary engorgement and the increased susceptibility of the nasopharynx to be traumatized [16,17]. Oxygen consumption is increased as well as alveolar ventilation.…”

Section: Maternal Anesthetic Aspects Of Fetal Surgerymentioning

confidence: 99%

Fetal and Maternal Analgesia/Anesthesia for Fetal Procedures

Velde

Buck

2012

Fetal Diagn Ther

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For many prenatally diagnosed conditions, treatment is possible before birth. These fetal procedures can range from minimal invasive punctions to full open fetal surgery. Providing anesthesia for these procedures is a challenge, where care has to be taken for both mother and fetus. There are specific physiologic changes that occur with pregnancy that have an impact on the anesthetic management of the mother. When providing maternal anesthesia, there is also an impact on the fetus, with concerns for potential negative side effects of the anesthetic regimen used. The question whether the fetus is capable of feeling pain is difficult to answer, but there are indications that nociceptive stimuli have a physiologic reaction. This nociceptive stimulation of the fetus also has the potential for longer-term effects, so there is a need for fetal analgesic treatment. The extent to which a fetus is influenced by the maternal anesthesia depends on the type of anesthesia, with different needs for extra fetal anesthesia or analgesia. When providing fetal anesthesia, the potential negative consequences have to be balanced against the intended benefits of blocking the physiologic fetal responses to nociceptive stimulation.

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Gestion des voies aériennes en obstétrique

Cited by 32 publications

References 95 publications

The predictive value of the ratio of neck circumference to thyromental distance in comparison with four predictive tests for difficult laryngoscopy in obstetric patients scheduled for caesarean delivery

The predictive value of the ratio of neck circumference to thyromental distance in comparison with four predictive tests for difficult laryngoscopy in obstetric patients scheduled for caesarean delivery

Anesthésie pour césarienne

Fetal and Maternal Analgesia/Anesthesia for Fetal Procedures

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