DAS: Difficult intubation in obstetrics

Question 1

Management after failed tracheal intubation but successful supraglottic airway insertion in obstetrics

Answer 1

Wake
- If possible
- Maintain oxygenation and cricoid
- Reverse rocuronium with sugammadex if used
- Anticipate laryngospasm
- Consider regional, ATI or high risk GA with 2-anaesthetists

Proceed with surgery
- Maintain anaesthetic
- Maintain ventilation: Can be controlled or spontaneous
- Minimise aspiration risk: continue cricoid if not impeeding ventilation, place OG tube and empty stomach, minimise fundal pressure
- Senior obstetrician
- Consider TIVA