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Master Thesis

Facteurs de risque d’intubation difficile et d’hypoxémie au cours de l’anesthésie générale pour césarienne en urgence : une étude prospective observationnelle multicentrique

Abstract : General anaesthesia (GA) for caesarean section is associated with maternal complications, especially during airway management, due to pregnancy-related physiological modifications. We prospectively assessed professional practices during induction of GA for emergency caesarean section in 17 maternities of the Ile-de-France region (2015-2016). We included 895 women. Half had a red code caesarean (n=439). Overall 40 (4,5%) difficult intubations were encountered, and 5 intubation failures (0,6%), all successfully managed by the insertion of a supraglottic device. No aspiration or other serious respiratory adverse events were reported. Difficult intubation was significantly associated with a Mallampati score > 2 (Odd Ratio = 2,4 IC 95% [1,2-4,7]), limited mandibular protrusion (5,7 [1,6-20]), limited mouth opening (3,8 [1,7-8,5]) and with the use of a hypnotic drug other than propofol (25 [2-391]) in multivariate analysis. Hypoxaemia (SpO2 = 95%) was observed in one out of five women, and significantly associated with difficult intubation (19,1 [8,6-42,7]) and a body mass index greater than 35 (0,5 [0,3-1,0]). In conclusion, difficult or failed intubation was observed in 5% of GA for emergency caesarean section, and was associated with a high incidence of hypoxaemia, and with the use of a hypnecd otic drug other than propofol.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03466772
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Submitted on : Monday, December 6, 2021 - 11:03:08 AM
Last modification on : Thursday, April 7, 2022 - 2:28:02 PM
Long-term archiving on: : Monday, March 7, 2022 - 6:30:08 PM

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Anne Galland. Facteurs de risque d’intubation difficile et d’hypoxémie au cours de l’anesthésie générale pour césarienne en urgence : une étude prospective observationnelle multicentrique. Médecine humaine et pathologie. 2020. ⟨dumas-03466772⟩

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