Fiberoptic intubation using intraoral glossopharyngeal nerve block in a patient with severe preeclampsia and HELLP syndrome

DʼAlessio, John G.; Ramanathan, Jaya

doi:10.1016/0959-289x(95)82974-f

Cited by 8 publications

(7 citation statements)

References 17 publications

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“…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%

“…Previous difficulty with airway management was noted in 14 women [8,9,15,28,34,35,44,46,53,54,77,84,97,121]. Specific pathology-related airway or respiratory investigations included two-dimensional airway reconstruction from CT images and intrathoracic anatomy [136].…”

Section: Airway Assessmentmentioning

confidence: 99%

“…HELLP syndrome [6,9]; a bitten and swollen tongue following an eclamptic fit [4]; and limited mouth opening [5,7,16,18,19,29,30,35,48]. The use of sedation and topical anaesthesia techniques was highly variable.…”

Section: Awake Tracheal Intubation Using the Flexible Bronchoscopementioning

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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Section: Resultsmentioning

confidence: 99%

Section: Airway Assessmentmentioning

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 chose to perform awake fibreoptic intubation because we obtained the necessary equipment from the general operating theatres and we routinely perform and teach this technique in nonobstetric patients and we have a high success rate. Although the technique of awake fibreoptic intubation is routine for patients with difficult airways in many institutions particularly in the USA, there are very few reports in obstetric patients [7][8][9][10][11][12].…”

Section: Discussionmentioning

confidence: 99%

“…Secondly, the effects of sedative drugs on the fetus should be considered. Although the procedure can be tolerated without sedation[11], all previous reports of awake fibreoptic intubation in obstetrics have used sedation in the form of opioids and/or benzodiazepines[7–10]. It is kinder to the mother if she is relaxed and unable to remember the procedure.…”

Section: Discussionmentioning

confidence: 99%

Awake fibreoptic intubation following failed regional anaesthesia for Caesarean section in a parturient with Still's disease

2000

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The anaesthetic management of a 25-year-old parturient with juvenile rheumatoid arthritis (Still's disease) and a difficult airway presenting for elective Caesarean section is described. Inadequate block after epidural anaesthesia necessitated general anaesthesia. This was safely accomplished by securing the airway with awake oral fibreoptic intubation before general anaesthesia was induced. The problems of performing an awake fibreoptic intubation in a pregnant patient are discussed and a simple method for performing the technique is described.

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Simulation of Difficult Airway Management in Obstetric Emergencies

Beck,

Salatto,

Ferrara

et al. 2023

Practical Guide to Simulation in Delivery Room Emergencies

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Fiberoptic intubation using intraoral glossopharyngeal nerve block in a patient with severe preeclampsia and HELLP syndrome

Cited by 8 publications

References 17 publications

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

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

Awake fibreoptic intubation following failed regional anaesthesia for Caesarean section in a parturient with Still's disease

Simulation of Difficult Airway Management in Obstetric Emergencies

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