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General Anesthesia in Cesarean Delivery Instances in the Era of Video Laryngoscopy: A Retrospective Review
Abstract Number: T210-521
Abstract Type: Original Research
The application of video laryngoscope greatly improved the visibility of patients’ airway, and the no cases of difficult intubation can be observed as the consequence.
We identified and collected information of 385 parturients who underwent cesarean section under GA from the Partners HealthCare electronic medical system from January 2016 to December 2018 by the submission date of abstract. The demographic information, indications for cesarean delivery, anesthesia techniques, mode of airway management, and surgery time were collected and analyzed. The one-sample ANOVA test was used to compare the demographic information of the population. The two-tailed T-test and chi-square test were used to compare the occurrences of cesarean deliveries under GA between this study and the previous study from the same institution for the period of 2000 to 2005.
From January 2016 to December 2018, 32.52% to 33.09% of total deliveries ranging from 11,697 to 15,044 cases every year were delivered through cesarean section. 2.55% to 3.22% of cesarean delivery cases were operated under GA. A statistically significant (p<0.001) increase can be observed when comparing the rate of cesarean deliveries that required GA from the period of 2000-2005 to the period of 2016-2018. There were sixteen cases of atraumatic repeated intubation attempts with one intubation instance that resulted in tracheal laceration. No difficult airway was identified, and no anesthesia-related mortality occurred. 14.3% overall increase (p=0.002) can be observed when comparing the application rate between the use of video laryngoscope and the use of direct laryngoscope from 2016 to 2018.
From the previous studies at Brigham and Women’s hospital, the conclusion was made that incidences of cesarean deliveries under GA were declining despite the fact that there was an increasing number of cesarean deliveries. Our study found that the rate of cesarean deliveries under GA is increasing over past decade, likely due to the more satisfying mode of airway management and usage of video laryngoscope. We will continue data collection and present the complete data set and analysis at SOAP.
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