title: Airway management for cesarean delivery performed under general anesthesia.
abstract: BACKGROUND
  With the increasing popularity of neuraxial anesthesia, there has been a decline in the use of general anesthesia for cesarean delivery. We sought to examine the incidence, outcome and characteristics associated with a failed airway in patients undergoing cesarean delivery under general anesthesia.
  
  
  METHODS
  A retrospective review of airway management in women undergoing cesarean delivery under general anesthesia over an eight-year period from 2006-2013 at an academic medical center was conducted.
  
  
  RESULTS
  During the study period, 10 077 cesarean deliveries were performed. Neuraxial anesthesia was used in 9382 (93%) women while general anesthesia was used in 695 (7%). Emergent cesarean delivery was the most common indication for general anesthesia. Failed intubation was encountered in only three (0.4%) women, who were successfully managed with a laryngeal mask airway. The overall incidence of failed intubation was 1 in 232 (95% CI 1:83 to 1:666) and general anesthesia was continued in all cases. There were no adverse maternal or fetal outcomes directly related to failed intubation.
  
  
  CONCLUSIONS
  Advances in adjunct airway equipment, availability of an experienced anesthesiologist and simulation-based teaching of failed airway management in obstetrics may have contributed to our improved maternal outcomes in patients undergoing cesarean delivery under general anesthesia.
authors.affiliation: Department of Anesthesiology, Baylor College of Medicine, Houston, TX, USA. Electronic address: srajagop@bcm.edu.
authors.forename: S
authors.initials: S
authors.lastname: Rajagopalan
authors.affiliation: Department of Anesthesiology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: M
authors.initials: M
authors.lastname: Suresh
authors.affiliation: Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Baylor College of Medicine, Houston, TX, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Clark
authors.affiliation: Department of Anesthesiology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: B
authors.initials: B
authors.lastname: Serratos
authors.affiliation: Department of Anesthesiology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: S
authors.initials: S
authors.lastname: Chandrasekhar
mesh_terms: D000328:Adult; D058109:Airway Management / Q000379:methods*; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods; D011247:Pregnancy; D012189:Retrospective Studies; D055815:Young Adult
keywords: Cesarean delivery; Failed intubation; General anesthesia