///2013 Abstract Details
2013 Abstract Details2019-08-02T16:57:45-05:00

Rate of Double Trouble in Obstetric Anesthesia

Abstract Number: F 31
Abstract Type: Original Research

Raymond Glassenberg MD1

Introduction: The phenomenon of double trouble (failed regional followed by difficult or failed rigid laryngoscopy) at C-section appears to be increasing over the past decade. The UK triennial reports, CEMACH (Confidential Enquires into Maternal and Child Health), from 1994 – 2005 do not list any cases of double trouble. In contrast, the 2008 NAP4 report of the Royal College of Anaesthetists reveals two of four cases of failed intubation during general anesthesia for c-section were associated with failed regional (1). What do the American data show?

Methods: A search was conducted of our IRB approved maternal airway database from 1974 – 2010 for double trouble. In addition, the ASA Closed Claims Project database was reviewed for this phenomenon (2).

Results: The risk in the US for double trouble ranges from 9% (4/45) nationally to 67% (6/9) in our institution. See table, where the first three rows are from our hospital.

Discussion: With the increased use of regional and decline in general anesthetics for C-section one would expect the rate for failed or difficult rigid laryngoscopy to increase. Extra vigilance should be used to maintain LMAs, video laryngoscopes and fiberoptic equipment in all obstetric suites.

References: (1)British Journal of Anaesthesia 106 (5): 617–31 (2011) (2) Karen Posner, personal communication, ASA Closed Claims Project.

SOAP 2013