Scott-Brown S, Russell R
Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, UK.
Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, UK.
Int J Obstet Anesth. 2015 May;24(2):137-46. doi: 10.1016/j.ijoa.2015.01.005. Epub 2015 Jan 23.
The pitfalls surrounding securing the airway in the obstetric patient are well documented. From Tunstall's original failed intubation drill onwards, there has been progress both in recognition of the difficulties of airway management in the pregnant patient and development of algorithms to enhance patient safety. Current trends in obstetric anaesthesia have resulted in a significant decrease in exposure of anaesthetists, especially trainees, to caesarean section under general anaesthesia, compounding the difficulties in safely managing the airway. Video laryngoscopes have recently appeared in airway algorithms. They improve glottic visualisation and are useful in the management of the difficult non-obstetric airway, including those in morbidly obese patients and in the setting of a rapid-sequence induction. There is growing interest in the potential use of video laryngoscopes in the obstetric population and as a teaching tool to maximise training opportunities.
产科患者气道安全保障方面存在的陷阱已有充分记录。从滕斯托尔最初的插管失败演练开始，在认识到孕妇气道管理的困难以及制定提高患者安全性的算法方面都取得了进展。产科麻醉的当前趋势导致麻醉医生，尤其是实习医生，进行全身麻醉下剖宫产的机会显著减少，这使得气道安全管理的难度进一步加大。视频喉镜最近已出现在气道管理算法中。它们能改善声门可视化，对困难非产科气道的管理很有用，包括病态肥胖患者以及快速顺序诱导情况下的气道管理。视频喉镜在产科人群中的潜在应用以及作为最大化培训机会的教学工具越来越受到关注。
