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. 2017 Feb 20;130(4):404-408.
doi: 10.4103/0366-6999.199833.

Laryngeal Mask Airway for Cesarean Delivery: A 5-Year Retrospective Cohort Study

Zhi-Yu Geng  1 , Dong-Xin Wang  1
Affiliations

Laryngeal Mask Airway for Cesarean Delivery: A 5-Year Retrospective Cohort Study

Zhi-Yu Geng et al. Chin Med J (Engl). .

Abstract

Background: The laryngeal mask airway (LMA) is the most commonly used rescue airway in obstetric anesthesia. The aim of this retrospective cohort study was to evaluate the application of the LMA in parturients undergoing cesarean delivery (CD) for 5 years in our hospital. As a secondary objective, we investigated the incidence of airway-related complication in obstetric general anesthesia (GA).

Methods: We collected electronic data for all obstetric patients who received GA for CD between January 2010 and December 2014 in Peking University First Hospital. Based on the different types of airway device, patients were divided into endotracheal intubation (ET) group and LMA group. The incidences of regurgitation and aspiration, as well as maternal and neonatal postoperative outcomes were compared between groups.

Results: During the 5-year study, GA was performed in 192 cases, which accounted for 2.0% of all CDs. The main indications for GA were contraindication to neuraxial anesthesia or a failed block. Among these, ET tube was used in 124 cases (68.9%) and LMA in 56 cases (31.1%). The percentage of critical patients above the American Society of Anesthesiologists' Grade II was 24/124 in ET group and 4/56 in LMA group (P = 0.036). The emergent delivery rate was 63.7% for ET group and 37.5% for LMA group (P = 0.001). None of the patients had regurgitation or aspiration. There were no significant differences in terms of neonatal Apgar scores, maternal and neonatal postoperative outcomes between the two groups.

Conclusions: Our results suggested that GA was mainly used for contraindication to neuraxial anesthesia or a failed block, and emergent CDs accounted for most cases. The second-generation LMA could be used for obstetric anesthesia, but correct position to achieve a good seal is the key to prevent reflux and aspiration. Whether they could replace the tracheal tube in routine practice needs further large prospective studies.

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Conflict of interest statement

There are no conflicts of interest.

References

    1. Quinn AC, Milne D, Columb M, Gorton H, Knight M. Failed tracheal intubation in obstetric anaesthesia: 2 year national case-control study in the UK. Br J Anaesth. 2013;110:74–80. doi: 10.1093/bja/aes320. - PubMed
    1. Mushambi MC, Kinsella SM, Popat M, Swales H, Ramaswamy KK, Winton AL, et al. Obstetric Anaesthetists’ Association and difficult airway society guidelines for the management of difficult and failed tracheal intubation in obstetrics. Anaesthesia. 2015;70:1286–306. doi: 10.1111/anae.13260. - PMC - PubMed
    1. Frerk C, Mitchell VS, McNarry AF, Mendonca C, Bhagrath R, Patel A, et al. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. Br J Anaesth. 2015;115:827–48. doi: 10.1093/bja/aev371. - PMC - PubMed
    1. McClune S, Regan M, Moore J. Laryngeal mask airway for caesarean section. Anaesthesia. 1990;45:227–8. doi: 10.1111/j.1365-2044.1990.tb14691.x. - PubMed
    1. Hasham FM, Andrews PJ, Juneja MM, Ackerman WE. The laryngeal mask airway facilitates intubation at cesarean section. A case report of difficult intubation. Int J Obstet Anesth. 1993;2:181–2. doi: 10.1016/0959-289X(93)90014-9. - PubMed