Thorin D, Ravussin P, De Grandi P
Département de gynécologie et obstétrique, CHUV, Lausanne.
Rev Med Suisse Romande. 1994 Jul;114(7):617-21.
The obstetrical population is prone to difficult or failed intubation. Control of the airway is complicated by several factors specific to obstetric anesthesia: time of apnea is short due to a reduced functional residual capacity and pregnancy-induced hypertension and obesity are relatively frequent; anesthetist's skill can also be mentioned. The best approach to this problem lies in its prevention, using epidural analgesia as soon as possible. Furthermore, the number of difficult intubations can be considerably reduced by a thorough pre-anesthetic examination. Each anesthetist must keep an algorithm in mind, should a difficult or failed intubation in obstetrical patient occur. Whichever method is used (ventilation through a facial mask or laryngeal mask, transtracheal oxygenation), the anesthetist must never forget that the first priority is always the safety of the mother.
产科人群容易出现插管困难或失败。气道控制因产科麻醉特有的几个因素而变得复杂:由于功能残气量减少,呼吸暂停时间较短,妊娠高血压和肥胖相对常见;麻醉医生的技术也会有影响。解决这个问题的最佳方法在于预防,尽早使用硬膜外镇痛。此外,通过全面的麻醉前检查可以显著减少困难插管的数量。如果产科患者出现困难插管或插管失败,每位麻醉医生都必须牢记一套操作流程。无论采用何种方法(通过面罩或喉罩通气、经气管给氧),麻醉医生绝不能忘记首要任务始终是母亲的安全。