Chapter 20 - The airway in obstetrics

Summary

Airway management is more difficult and stressful in obstetrics, and the consequences of difficulty are more serious than in many other areas. Most problems involve general anaesthesia although airway management may be required in regional anaesthesia. One advantage of regional anaesthesia, if not the main one, is the avoidance in most cases of the need for airway support. Apart from the possible contribution of reduced training in airway management and obstetric general anaesthesia, another factor that might lead to a higher reported incidence is that trainees are now taught to declare failure earlier rather than persist with attempts to intubate. The value of a drill in the management of difficult/failed intubation has long been recognised and a modern, simplified version is offered. Care must also be taken with tracheal extubation, especially if there is a risk of laryngeal oedema, perhaps exacerbated by intubation, for example in pre-eclampsia.