A Case Report of a Rescue of Unanticipated Obstetric Difficult Airway Secondary to Limited Mouth Opening With i-gel® and Establishing Definitive Airway With Aintree and Fiberscope-Guided Intubation

Abstract

Obstetric difficult airway management has emerged as a critical safety issue, and unsuccessful intubation can lead to morbidity and mortality. A literature review of difficult and failed obstetric intubations from the 1970s to 2015 shows that the incidence of failed intubation is unchanged, remaining at one per 390 anesthetics. Our obstetric case report highlights an obstetric difficult airway secondary to limited mouth opening; rescue of the airway with an i-gel®; and establishment of a definitive airway with the aid of an Aintree intubation catheter and flexible fiberoptic scope-guided intubation through the i-gel®, a second-generation supraglottic airway.

Keywords: general anesthesia in Cesarean delivery; intubation with i-gel® and flexible fiberscope intubation; limited mouth opening; masseter muscle rigidity after succinylcholine; obstetric difficult airway; obstetric difficult airway management; second-generation supraglottic airway device; video-assisted laryngoscopy.