Awake fibreoptic intubation, airway compression and lung collapse in a parturient: anaesthetic and intensive care management

Boyne, I.; O'Connor, R.; Marsh, Deborah S.

doi:10.1016/s0959-289x(99)80012-0

Cited by 7 publications

(7 citation statements)

References 15 publications

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“…There are several reported cases in the literature of pregnant patients with mediastinal masses having cesarean deliveries under regional anaesthesia [1,11]. There are also reports of general anaesthesia being used due to patient's inability to lay supine for the procedure [12]. The benefit of general anaesthesia in our case would have been one anaesthetic only, performed for both procedures.…”

Section: Discussionmentioning

confidence: 80%

Cesarean Delivery in the Bronchoscopy Suite in a Patient with an Anterior Mediastinal Mass

Galway¹,

Gildea²,

Parker³

et al. 2021

SCR

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Mediastinal masses pose a significant challenge for anesthesiologists due to the risk of cardiorespiratory collapse. Pregnancy in of itself causes multiple detrimental changes to respiratory physiology. We present a case of cesarean delivery performed in the bronchoscopy suite followed by bronchoscopic airway evaluation in a patient at 33 weeks gestation with symptomatic anterior mediastinal mass. We discuss the multidisciplinary approach and anaesthetic management of this complicated case.

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Section: Discussionmentioning

confidence: 80%

Cesarean Delivery in the Bronchoscopy Suite in a Patient with an Anterior Mediastinal Mass

Galway¹,

Gildea²,

Parker³

et al. 2021

SCR

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“…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.…”

Section: Resultsmentioning

confidence: 99%

“…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.…”

Section: Resultsmentioning

confidence: 99%

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

2020

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We reviewed the literature on management of general and regional anaesthesia in pregnant women with anticipated airway difficulty. We identified 138 publications comprising 158 cases; these either described equipment or techniques for the provision of general anaesthesia, or the management of women with regional analgesia or anaesthesia, with the aim of avoiding general anaesthesia. Most of the former group described women requiring caesarean section alone, or in combination with other surgery, which was sometimes airwayrelated. Management techniques were largely similar to those in non-obstetric patients requiring surgery who have airway difficulties, although suggested differences related to physiological changes of pregnancy and avoidance of nasal intubation. In the reports discussing regional anaesthesia, consideration was often given to the possible requirement for urgent out-of-hours anaesthetic intervention, and the predicted difficulty of management of general anaesthesia should it be required. In a number of reported cases, multidisciplinary planning led to the conclusion that elective caesarean section should be performed in order to avoid emergency airway management. Based on this literature review, we advise antenatal planning that includes: assessment of the patient's clinical characteristics; consideration of the equipment and personnel available to provide safe airway management out-of-hours; and elective caesarean section should these be lacking. If general anaesthesia is required, a risk assessment must be made as to the probability of safe airway management after the induction of anaesthesia, and awake tracheal intubation should be used if this cannot be assured. Decision aids are provided to illustrate these points. Online appendices include a comprehensive compendium of case reports on the management of a number of rare syndromes and airway conditions.

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“…Very few anesthesiologists have regular exposure to cases like this, which adds to the uncertainty. [1][2][3][4] Guidance from the literature is problematic because it is a collection of case reports offering examples of masses that were treated successfully and unsuccessfully. 4 Textbooks are no longer the gold standard because they are often outdated and tend to focus on theoretical principles that are difficult to translate into clinical practice.…”

Section: Perioperative Managementmentioning

confidence: 99%

Perioperative Management of the Pregnant Patient with an Anterior Mediastinal Mass

Kanellakos

2012

Anesthesiology Clinics

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Awake fibreoptic intubation, airway compression and lung collapse in a parturient: anaesthetic and intensive care management

Cited by 7 publications

References 15 publications

Cesarean Delivery in the Bronchoscopy Suite in a Patient with an Anterior Mediastinal Mass

Cesarean Delivery in the Bronchoscopy Suite in a Patient with an Anterior Mediastinal Mass

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

Perioperative Management of the Pregnant Patient with an Anterior Mediastinal Mass

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