31 - General anaesthesia and failed intubation

Summary

Major complications of general anaesthesia include failed intubation, aspiration of gastric contents, increased blood loss and awareness. A thorough airway evaluation must be performed on all patients presenting for general anaesthesia to identify those with anticipated airway difficulties. Most general anaesthetics are administered in emergency situations therefore drugs and equipment must be prepared in advance. Women in labour at high risk of surgical intervention should receive regular prophylactic antacid medication. The purpose of rapid sequence induction is to secure a defnitive airway with a cufed endotracheal tube as quickly as possible in patients at high risk of aspiration. A neonatal resuscitation team must be in attendance for all deliveries requiring general anaesthesia. Cricothryroidotomy is a life-saving rescue airway procedure performed in cases of severe hypoxia when all other airway manouvres have been unsuccessful. Mandatory capnography should be done to confirm correct endotracheal tube placement.