Airway management for 362 cesarean deliveries performed with general anesthesia at a Texas level IV maternal facility

Abstract

At our hospital, direct and video laryngoscopy are used in airway management for cesarean deliveries performed with general anesthesia. We hypothesized that video laryngoscopy would have a higher success rate of endotracheal intubation on the first attempt compared to direct laryngoscopy. We used our electronic medical record system to search for patients who had cesarean deliveries with general anesthesia with endotracheal intubation performed in the operating room from July 1, 2017, through June 30, 2021. Totals of 186 and 176 patients had direct and video laryngoscopy for the first intubation attempts, respectively; 177 (95%) and 163 (93%) patients, respectively, had a successful intubation on the first attempt with each method. The odds ratio of successful intubation on the first attempt for video laryngoscopy was 0.64 (95% CI 0.27, 1.53; P = 0.31) compared to patients who had direct laryngoscopy. There was no statistically significant difference in Cormack-Lehane grade views of the glottis between direct and video laryngoscopy on the first attempt. In conclusion, there was no statistically significant improvement in the success rate of intubation on the first attempt when video laryngoscopy was used for patients undergoing general anesthesia for cesarean delivery.