Anaes SAQs · Airway management
Failed intubation in obstetrics — the drill
Final-viva question on the obstetric failed-intubation drill, the wake-up-versus-proceed decision, supraglottic-airway rescue, and the risk factors and physiological changes that make the obstetric airway dangerous.
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Prompt
A 32-year-old morbidly obese parturient at 39 weeks requires an emergency caesarean section under general anaesthesia for a prolonged bradycardia. After preoxygenation and rapid sequence induction, the best laryngoscopist cannot intubate on two optimised attempts and the saturation is falling. Outline your subsequent management.
Question
A 32-year-old morbidly obese parturient at 39 weeks requires an emergency caesarean section under general anaesthesia for a prolonged bradycardia. After preoxygenation and rapid sequence induction, the best laryngoscopist cannot intubate on two optimised attempts and the saturation is falling. Outline your subsequent management[2][1].
References4ShowHide
- [1]Craig R, et al. Best practice in obstetric general anaesthesia: an umbrella review of pharmacological strategies for induction of general anaesthesia. Anaesthesia, 2026.PMID 41987713
- [2]Ramkumar V, et al. All India Difficult Airway Association 2025 guidelines for the management of unanticipated difficult airway in obstetrics under general anaesthesia. Indian J Anaesth, 2025.PMID 41293137
- [3]Saracoglu A, et al. Airway events in pregnant patients with morbid obesity undergoing caesarean delivery under general anaesthesia: a retrospective cohort study (2015-2024). Int J Obstet Anesth, 2026.PMID 41240486
- [4]Mushambi MC, Kinsella SM, Popat M, et al. Obstetric Anaesthetists' Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics. Anaesthesia, 2015.PMID 26449292