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Failed intubation in obstetric general anaesthesia - interim results of a national UK survey.
Abstract Number: 108
Abstract Type: Case Report/Case Series
Introduction: Reports from the UK Confidential Enquiry into Maternal and Child Health have shown a decrease in the number of anaesthetic related deaths over recent years(1). However, a consistent cause of death is hypoxia relating to a failure to intubate and ventilate. The incidence of failed intubation among the pregnant population has been estimated to be up to 8 times that of the non-pregnant population in previous studies(2,3). However, a more recent study had no cases of failed intubation in a set of 3430 general anaesthetic cases(4). As yet, no UK national data exist. This study aims to calculate a national incidence for failed intubation in obstetric general anaesthesia.
Methods: A national surveillance and case control study using the UK Obstetric Surveillance System (UKOSS). Cases were defined as any woman of over 20 weeks gestation given a general anaesthetic (whether on delivery suite or another hospital department) where failed intubation has occurred. Controls were defined as the previous 2 general anaesthetics without failed intubation. Data collection commenced in April 2008, and the following is a summary of the interim results.
Results: see table
Conclusion: It is difficult to draw firm conclusions from this interim dataset. It seems that there are fewer failed intubations than may have been predicted by some other studies(2,3) but clearly not as low as the recent study in Liverpool(4). It is hoped that all data will be collected later in 2010 for fuller analysis.
We would like to thank the OAA and UKOSS for their support.
1. Lewis G. (Ed) The Confidential Enquiry into Maternal and CHild Health (CEMACH). Saving Mothers Lives: reviewing maternal deaths to make childhood safer - 2003-2005. London: CEMACH, 2007.
2. Rahman K, Jenkins JG. Failed tracheal intubation in obstetrics: no more frequent but still managed badly. Anaesthesia 2005; 60: 168-71.
3. Hawthorne I, Wilson R, Lyons G, Dresner M.Failed intubation revisited: 17-yr experience in a teaching maternity unit. British Journal of Anaesthesia 1996; 76: 680-4.
4. Djabatey EA, Barclay PM. Difficult and failed intubation in 3430 obstetric general anaesthetics. Anaesthesia 2009, 64: 1168-1171