Relative Risk Analysis of Factors Associated with Difficult Intubation in Obstetric Anesthesia

Rocke, D. A.; Murray, W. Bosseau; Rout, C C; Gouws, Eleanor

doi:10.1097/00000542-199207000-00010

Cited by 360 publications

(83 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Combinations of various measurements in a multivariate model are being used in the hope of improving the ability to predict (sensitivity and specificity) difficult intubation. 5 Despite the abundance of literature in this area (more than 1700 manuscripts referenced in the National Library of Medicine), the tools used to measure the relevant criteria are often not described. 6 How are these measurements taken?…”

Section: Prediction Of Difficult Intubation: Are We Talking About Thementioning

confidence: 99%

An aid to correct positioning of the ProSeal laryngeal mask

Drolet¹,

Girard²

2001

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Section: Prediction Of Difficult Intubation: Are We Talking About Thementioning

confidence: 99%

An aid to correct positioning of the ProSeal laryngeal mask

Drolet¹,

Girard²

2001

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

“…The relative risk of experiencing a difficult intubation in comparison to an uncomplicated class I airway increases by four times when the airway class changes from class 2 to class 4 airway. 7 The risk may increase further if the patient has other risk factors such as obesity, protruding upper teeth, short thyromental distance, and increased weight gain in the pregnancy. 8 In addition, the laryngeal edema that may accompany upper airway edema can also contribute to a difficult intubation.…”

Section: Discussionmentioning

confidence: 99%

Airway changes during cesarean hysterectomy

Bhavani-Shankar

Lynch

Datta

2000

Can J Anesth/J Can Anesth

View full text Add to dashboard Cite

Purpose: To document whether hemorrhage and fluid administration during peripartum hysterectomy results in changes in the airway that may predispose to subsequent difficult intubation, in the event that intraoperative general anesthesia is required during regional anesthesia.Clinical features: A 32-yr-old underwent peripartum hysterectomy for placenta accreta. Blood loss of 5.5 L occurred during surgery requiring 6 L crystalloid, 1 L hetastarch, five units packed RBCs and two units fresh frozen plasma. Airway changes were followed using Samsoon's modification of Mallampati airway classification. In addition, airway photographs were obtained using a Polaroid camera. The airway of the patient changed from class 2 preoperatively to class 4 in the immediate postoperative period. The airway gradually returned to normal over the ensuing 48 hr, during which a negative fluid balance of 4 L occurred due to substantial postoperative diuresis.Conclusion: Peripartum airway changes were detected during Cesarean hysterectomy and fluid resuscitation that gradually returned to normal within 48 hr after surgery.Objectif : Vérifier si une hémorragie et l'administration de liquide pendant une hystérectomie péripartum peut modifier l'intubation prédisposant à une intubation difficile subséquente, dans le cas où une anesthésie générale peropératoire serait nécessaire pendant l'anesthésie régionale.Éléments cliniques : Une femme de 32 ans a subi une hystérectomie péripartum à cause d'un placenta accreta. Une perte sanguine de 5,5 L est survenue pendant l'opération et a nécessité 6 L de cristalloïde, 1 L de hetastarch, cinq culots globulaires et deux unités de plasma frais congelé. Les changements de l'intubation ont été observés grâce à la modification de Samsoon de la classification de Mallampati. De plus, des photographies de l'intubation ont été réalisées avec une caméra Polaroïd. L'intubation du patient est passée de la classe 2, avant l'opéra-tion, à la classe 4, immédiatement après. Elle est graduellement revenue à la normale au cours des 48 h qui ont suivi et durant lesquelles un bilan hydrique négatif de 4 L est survenu, causé par une importante diurèse postopératoire.Conclusion : Les changements dans l'intubation péripartum ont été détectés pendant l'hystérectomie postcésari-enne et la réanimation liquidienne qui se sont graduellement normalisés pendant les 48 h qui ont suivi l'intervention chirurgicale.

show abstract

“…The most important additional factors, especially with a Mallampati Class 2, are: short neck, receding mandible, and protruding maxillary incisors. 23 In this case, the patient had at least six previous operations. Did she have a previous airway problem?…”

Section: Difficult Airway and Regional Anaesthesiamentioning

confidence: 97%