Davies J M, Weeks S, Crone L A, Pavlin E
Department of Anaesthesia, Foothills Hospital, Calgary, Alberta.
Can J Anaesth. 1989 Nov;36(6):668-74. doi: 10.1007/BF03005419.
Difficult or failed tracheal intubation is an important cause of anaesthetic-related maternal morbidity and mortality. The incidence of failed intubation in parturients is estimated to be as frequent as 1 in 500; that of mortality is unknown, although some 10-13 pregnant women in England, Scotland and Wales die each year because of anaesthetic-related complications. To prevent such catastrophes, all necessary monitors and equipment should be available, including that needed to deal with a failed intubation. Assessment of the patient may lead to preoperative recognition of a difficult airway; altered positioning may be of help both in recognition and management. Furthermore, adequate assistance, correct use of cricoid pressure, and confirmation of tracheal intubation are fundamental to safe practice. Lastly, should the anaesthetist fail to intubate the patient's trachea, a management protocol is suggested.
困难气管插管或插管失败是麻醉相关孕产妇发病和死亡的重要原因。产妇插管失败的发生率估计高达每500例中就有1例；死亡率尚不清楚，尽管在英格兰、苏格兰和威尔士每年约有10 - 13名孕妇因麻醉相关并发症死亡。为防止此类灾难发生，应备有所有必要的监测设备和器材，包括处理插管失败所需的设备。对患者的评估可能有助于术前识别困难气道；改变体位在识别和处理方面可能有所帮助。此外，足够的协助、正确使用环状软骨压迫法以及确认气管插管是安全操作的基础。最后，如果麻醉医生未能成功为患者进行气管插管，建议采用一套处理方案。
