Chapter 18 - Controversies surrounding airway management and cesarean delivery

Summary

This chapter reviews the data on maternal mortality with an emphasis on the deaths related to failed intubation. It explores the role of video laryngoscope and supraglottic airways in managing the parturient's airway. The chapter further talks about induction agents and muscle relaxants used in anesthesia for cesarean section (CS). It discusses the role simulation plays in resident education related to airway management, as clinical exposure to general anesthesia for CS remains limited. Marked physiological changes occur during pregnancy, which can make the maternal airway difficult to manage in terms of mask ventilation and intubation. Rapid sequence induction (RSI) is the standard of practice during induction of general anesthesia for CS. Along with preoxygenation and denitrogenation, cricoid pressure (CP) is applied prior to the induction agent being administered. The larnygeal mask airway (LMA) has been a significant advance in airway management in parturients.