Failed intubation in a parturient with spina bifida.
We describe a case of unexpected difficult intubation and ventilation during induction of general anaesthesia for caesarean section. This case was particularly challenging as the parturient suffered with particularly severe cord tethering following surgery for spina bifida as a child. The observed change in anticipated intubation difficulty during pregnancy, and the use of the laryngeal mask airway as a life-saving device in obstetrics are described. Consideration of the difficulties of anaesthetising the patient with spina bifida for caesarean section in general, and the issues relevant in deciding whether to continue with surgery or to wake the patient up in particular are discussed. Suggestions are made for the management of this emergency situation in those not skilled in fibreoptic intubation.
Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, UK. keithboy@gasman61.freeserve.co.uk
K J
KJ
Anderson
M J
MJ
Quinlan
M
M
Popat
R
R
Russell