Anesthetic challenges of pregnant obesity women.

Obesity causes significant morbidity and increases the mortality risk for both mother and fetus. With an increasing projected prevalence, it is vital that the obstetric anesthetist is equipped with the knowledge and tools to manage these women. A multi-disciplinary team approach and early planning is required.

The role of supraglottic airway devices in obstetric anaesthesia.

Purpose Of Review: To discuss the role of supraglottic airway devices as rescue and primary airway devices in pregnant patients.

Recent Findings: General anaesthesia in pregnant patients is associated with increased incidence of difficult and failed intubation, especially when performed for caesarean deliveries. The Difficult Airway Society and the Obstetric Anaesthetists' Association guidelines for the management of failed intubation recommend the use of second-generation supraglottic airway devices as a rescue airway strategy when failed intubation occurs.

Peri-intubation oxygenation for Caesarean delivery: is there an optimal technique?

Peri-intubation oxygen administration to the pregnant patient during induction of general anaesthesia is critical to avoiding hypoxaemia and harm to the mother and fetus. Recent modelling comparing low-flow with high-flow nasal oxygen in simulated term pregnant women of varying body habitus, taken together with previous work, suggests that face mask preoxygenation with the use of low-flow or high-flow nasal oxygen during the period of apnoea prolongs the safe apnoea period, with the benefit varying by body habitus. Low-flow compared with high-flow nasal oxygen may be easier to combine with face mask preoxygenation and is readily available in all operating theatres, although future improvements in high-flow nasal oxygen delivery systems may improve ease of use for this indication.

Persistent headache and low back pain after accidental dural puncture in the obstetric population: a prospective, observational, multicentre cohort study.

Accidental dural puncture following epidural insertion can cause a post-dural headache that is defined by the International Headache Society as self-limiting. We aimed to confirm if accidental dural puncture could be associated with persistent headache and back pain when compared with matched control parturients. We performed a prospective multicentre cohort study evaluating the incidence of persistent headache following accidental dural puncture at nine UK obstetric units.

Airway management guidance for the endemic phase of COVID-19.

It is now apparent that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19) will remain endemic for some time. Improved therapeutics and a vaccine may shorten this period, but both are far from certain. Plans must be put in place on the assumption that the virus and its disease will continue to affect the care of patients and the safety of staff.

Anticipated difficult airway during obstetric general anaesthesia: narrative literature review and management recommendations.

We reviewed the literature on management of general and regional anaesthesia in pregnant women with anticipated airway difficulty. We identified 138 publications comprising 158 cases; these either described equipment or techniques for the provision of general anaesthesia, or the management of women with regional analgesia or anaesthesia, with the aim of avoiding general anaesthesia. Most of the former group described women requiring caesarean section alone, or in combination with other surgery, which was sometimes airway-related.

Regional anaesthesia with extracorporeal membrane oxygenation backup for caesarean section in a parturient with neck and mediastinal masses.

Mediastinal mass in pregnancy is a rare condition that presents significant anaesthetic challenges. We present a woman with relapsed Hodgkin's lymphoma during pregnancy who declined to have chemotherapy because of concerns for her unborn child. She failed to attend follow-up clinic appointments and presented at 33 weeks' gestation with tracheal deviation and narrowing down to the level of the carina, as a result of large neck and mediastinal masses.

High-flow humidified nasal oxygenation vs. standard face mask oxygenation.

Ten healthy volunteers received oxygen for 1 min, 2 min and 3 min at 10 l.min via a face mask, or humidified oxygen at 60 l.min via nasal prongs (Optiflow ) with the mouth closed and with the mouth open.

Airway management and training in obstetric anaesthesia.

Purpose Of Review: Airway management and failed intubation in the pregnant woman requires unique considerations, which differ from the nonpregnant patient. Factors that influence airway management in this setting include anatomical and physiological changes in pregnancy, environmental factors as well as training matters. In addition, surgery is often being performed with extreme urgency, which requires rapid decision-making process that takes into account safe outcome of mother and baby.

Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics.

The Obstetric Anaesthetists' Association and Difficult Airway Society have developed the first national obstetric guidelines for the safe management of difficult and failed tracheal intubation during general anaesthesia. They comprise four algorithms and two tables. A master algorithm provides an overview.

Failed tracheal intubation during obstetric general anaesthesia: a literature review.

We reviewed the literature on obstetric failed tracheal intubation from 1970 onwards. The incidence remained unchanged over the period at 2.6 (95% CI 2.

Airway management in patients.

Stridor is caused by turbulent flow through a narrow airway. Common causes of stridor are deep neck infection, malignancy, angioneurotic oedema, trauma and congenital anomalies like laryngomalacia. The majority of these conditions can progress rapidly to complete airway obstruction.