Skip to main content
SpringerLink
Log in
Book cover

Pulmonary Problems in Pregnancy pp 107–120Cite as

Anesthetic Considerations in Pregnant Patients with Pulmonary Disorders

  • Chapter
  • First Online:

  • 1087 Accesses

Part of the book series: Respiratory Medicine ((RM))

Anesthesia care in obstetrics includes three basic domains: neuraxial blocks for labor analgesia, examples being epidural, spinal, or combined spinal-epidural (CSE) analgesia; anesthesia for cesarean delivery, examples being spinal, CSE, epidural, or general anesthesia; anesthesia for miscellaneous procedures such as cerclage, removal of a retained placenta, or postpartum tubal ligation.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Hawkins JL, Koonin LM, Palmer SK, Gibbs CP. Anesthesia-related deaths during obstetric delivery in the United States, 1979–1990. Anesthesiology 1997;86:277–84.

    Article  PubMed  CAS  Google Scholar 

  2. Cooper GM, McClure JH. Maternal deaths from anaesthesia. An extract from Why Mothers Die 2000–2002, the Confidential Enquiries into Maternal Deaths in the United Kingdom. Br J Anaesth 2005;94:417–23.

    CAS  Google Scholar 

  3. Ng A, Smith G. Gastroesophageal reflux and aspiration of gastric contents in anesthetic practice. Anesth Analg 2001;93:494–513.

    PubMed  CAS  Google Scholar 

  4. Davison JS, Davison MC, Hay DM. Gastric emptying time in late pregnancy and labour. J Obstet Gynaecol Br Commonw 1970;77:37–41.

    Article  PubMed  CAS  Google Scholar 

  5. Carp H, Jayaram A, Stoll M. Ultrasound examination of the stomach contents. Anesth Analg 1992;74:683–7.

    Article  PubMed  CAS  Google Scholar 

  6. Scrutton MJL, Metcalfe GA, Lowy C, Seed PT, O'Sullivan G. Eating in labour: a randomized controlled trial assessing risks and benefits. Anaesthesia 1999;4:329–34.

    Article  Google Scholar 

  7. Kelly MC, Carabine UA, Hill DA, Mirakhur RK. A comparison of the effect of intrathecal and extradural fentanyl on gastric emptying in laboring women. Anesth Analg 1997;85:834–8.

    PubMed  CAS  Google Scholar 

  8. Porter JS, Bonello E, Reynolds F. The influence of epidural administration of fentanyl infusion on gastric emptying in labour. Anaesthesia 1997;52:1151–6.

    Article  PubMed  CAS  Google Scholar 

  9. Samsoon GLT, Young JRB. Difficult tracheal intubation: a retrospective study. Anaesthesia 1987;42:487–90.

    Article  PubMed  CAS  Google Scholar 

  10. Rocke DA, Murray WB, Rout CC, Gouws E. Relative risk analysis of factors associated with difficult intubation in obstetric anesthesia. Anesthesiology 1992;77:67–73.

    Article  PubMed  CAS  Google Scholar 

  11. American Society of Anesthesiologists. Practice guidelines for management of the difficult airway. Anesthesiology 2003;98:1269–77.

    Article  Google Scholar 

  12. Pilkington S, Carli F, Dakin MJ, et al. Increase in Mallampati score during pregnancy. Br J Anaesth 1995;74:638–42.

    Article  PubMed  CAS  Google Scholar 

  13. Farcon EL, Kim MH, Marx GF. Changing Mallampati score during labour. Can J Anaesth 1994;41:50–1.

    Article  PubMed  CAS  Google Scholar 

  14. Brimacombe J. Acute pharyngolaryngeal oedema and pre-eclamptic toxaemia. Anaesth Intensive Care 1992;20:97–8.

    PubMed  CAS  Google Scholar 

  15. Izci B, Riha RL, Martin SE, et al. The upper airway in pregnancy and pre-eclampsia. Am J Respir Crit Care Med 2003;167:137–40.

    Article  PubMed  Google Scholar 

  16. Saah D, Braverman I, Elidan J, Nageris B. Traumatic macroglossia. Ann Otol Rhinol Laryngol 1993;102:729–30.

    PubMed  CAS  Google Scholar 

  17. Archer GW Jr, Marx GF. Arterial oxygen tension during apnoea in parturient women. Br J Anaesth 1974;46:358–60.

    Article  PubMed  Google Scholar 

  18. De Swiet M. The respiratory system. In: Hytten F, Chamberlin G, Eds). Clinical Physiology in Obstetrics, Chapter 3. 2nd ed. Oxford: Blackwell, 1991;83–100.

    Google Scholar 

  19. Eliasson AH, Phillips YY, Stajduhar KC, Carome MA, Cowsar JD Jr. Oxygen consumption and ventilation during normal labor. Chest 1992;102:467–71.

    Article  PubMed  CAS  Google Scholar 

  20. Staten MA, Matthews DE, Cryer PE, Bier DM. Physiological increments in epinephrine stimulate metabolic rate in humans. Am J Physiol 1987;253:E322–30.

    Google Scholar 

  21. Chiron B, Laffon M, Ferrandiere M, Pittet JF, Marret H, Mercier C. Standard preoxygenation technique versus two rapid techniques in pregnant patients. Int J Obstet Anesth 2004;13:11–4.

    Article  PubMed  CAS  Google Scholar 

  22. Martyn JAJ, Richtsfeld M. Succinylcholine-induced hyperkalemia in acquired pathologic states: etiologic factors and molecular mechanisms. Anesthesiology 2006; 104:158–69.

    Article  PubMed  CAS  Google Scholar 

  23. Litman RS, Rosenberg H. Malignant hyperthermia: update on susceptibility testing. JAMA 2005;293:2918–24.

    Article  PubMed  CAS  Google Scholar 

  24. Rosenbaum HK, Miller JD. Malignant hyperthermia and myotonic disorders. Anesthesiol Clin NA 2002;20:623–64.

    Article  Google Scholar 

  25. Kerr MG, Scott DB, Samuel E. Studies of the inferior vena cava in late pregnancy. Br Med J 1964;1:532–3.

    PubMed  CAS  Google Scholar 

  26. Hawthorne L, Wilson R, Lyons G, Dresner M. Failed intubation revisited: 17-year experience in a teaching maternity unit. Br J Anaesth 1996;76:680–4.

    PubMed  CAS  Google Scholar 

  27. Barnado PD, Jenkins JG. Failed tracheal intubation in obstetrics: a 6-year review in a UK region. Anaesthesia 2000;55:685–94.

    Article  Google Scholar 

  28. Rahman K, Jenkins JG. Failed tracheal intubation in obstetrics: no more frequent but still managed badly. Anaesthesia 2005;60:168–71.

    Article  PubMed  CAS  Google Scholar 

  29. Gambling DR, Shay DC. The mother of all breathing problems. J Clin Anesth 2003;15:491–4.

    Article  PubMed  Google Scholar 

  30. Russell R. Failed intubation in obstetrics: a self-fulfilling prophecy? Int J Obstet Anesth 2007;16:1–3.

    Article  PubMed  Google Scholar 

  31. Hood DD, Dewan DM. Anesthetic and obstetric outcome in morbidly obese parturients. Anesthesiology 1993;9:1210–8.

    Article  Google Scholar 

  32. Langeron O, Masso E, Hurax C, et al. Prediction of difficult mask ventilation. Anesthesiology 2000;92:1229–36.

    Article  PubMed  CAS  Google Scholar 

  33. Mhyre JM, Riesner MN, Polley LS, Naughton NN. A series of anesthesia-related maternal deaths in Michigan, 1985–2003. Anesthesiology 2007;106:1096–104.

    Article  PubMed  Google Scholar 

  34. Freund FG, Bonica JJ, Ward RJ, Akamatsu TJ, Kennedy WF Jr. Ventilatory reserve and level of motor block during high spinal and epidural anesthesia. Anesthesiology 1967;28:834–7.

    Article  PubMed  CAS  Google Scholar 

  35. Takasaki M, Takahashi T. Respiratory function during cervical and thoracic extradural analgesia in patients with normal lungs. Br J Anaesth 1980;52:1271–6.

    Article  PubMed  CAS  Google Scholar 

  36. von Ungern-Sternberg BS, Regli A, Reber A, Schneider MC. Comparison of perioperative spirometric data following spinal or general anaesthesia in normal-weight and overweight gynaecological patients. Acta Anaesthesiol Scand 2005;49:940–8.

    Article  Google Scholar 

  37. Regli A, von Ungern-Sternberg BS, Reber A, Schneider MC. Impact of spinal anaesthesia on peri-operative lung volumes in obese and morbidly obese female patients. Anaesthesia 2006;61:215–21.

    Google Scholar 

  38. Gamil M. Serial peak expiratory flow rates in mothers during caesarean section under extradural anaesthesia. Br J Anaesth 1989;62:415–8.

    Article  PubMed  CAS  Google Scholar 

  39. von Ungern-Sternberg BS, Regli A, Bucher E, Reber A, Schneider MC. Impact of spinal anaesthesia and obesity on maternal respiratory function during elective caesarean section. Anaesthesia 2004;59:743–9.

    Article  Google Scholar 

  40. Harrop-Griffiths AW, Ravalia A, Browne DA, Robinson PN. Regional anaesthesia and cough effectiveness: a study in patients undergoing caesarean section. Anaesthesia 1991;46:11–3.

    Article  PubMed  CAS  Google Scholar 

  41. Kelly MC, Fitzpatrick KTJ, Hill DA. Respiratory effects of spinal anaesthesia for caesarean section. Anaesthesia 1996;51:1120–2.

    Article  PubMed  CAS  Google Scholar 

  42. McCool FD. Global physiology and pathophysiology of cough: ACCP evidence-based clinical practice guidelines. Chest 2006;129:48S–53S.

    Article  PubMed  Google Scholar 

  43. Egbert LD, Tmersoy K, Deas TC. Pulmonary function during spinal anesthesia: the mechanism of cough depression. Anesthesiology 1961;22:882–5.

    Article  PubMed  CAS  Google Scholar 

  44. von Ungern-Sternberg BS, Regli A, Bucher E, Reber A, Schneider MC. The effect of epidural analgesia in labour on maternal respiratory function. Anaesthesia 2004; 59:350–3.

    Article  Google Scholar 

  45. Sangoul F, Fox GS, Houle GL. Effect of regional anesthesia on maternal oxygen consumption during the first stage of labor. Am J Obstet Gynecol 1975;121:1080–3.

    PubMed  CAS  Google Scholar 

  46. Haegerdal M, Morgan CW, Sumner AE, Gutsche BB. Minute ventilation and oxygen consumption during labor with epidural analgesia. Anesthesiology 1983;59:425–7.

    Article  CAS  Google Scholar 

  47. Ackerman WE, Molnar JM, Juneja MM. Beneficial effect of epidural anesthesia on oxygen consumption in a parturient with adult respiratory distress syndrome. South Med J 1993;86:361–4.

    Article  PubMed  Google Scholar 

  48. Mallampati SR. Bronchospasm during spinal anesthesia. Anesth Analg 1981;60:839–40.

    Article  PubMed  CAS  Google Scholar 

  49. Wang CY, Ong GSY. Severe bronchospasm during epidural anesthesia. Anaesthesia 1993;48:514–5.

    Article  PubMed  CAS  Google Scholar 

  50. Groeben H, Schwalen A, Irsfeld S, Tarnow J, Lipfert P, Hopf HB. High thoracic epidural anesthesia does not alter airway resistance and attenuates the response to an inhalational provocation test in patients with bronchial hyperreactivity. Anesthesiology 1994;81:868–74.

    Article  PubMed  CAS  Google Scholar 

  51. Shono S, Higa K, Harasawa I, Sugano H, Dan K. Disappearance of wheezing during epidural lidocaine anesthesia in a patient with bronchial asthma. Reg Anesth Pain Med 1999;24:463–6.

    PubMed  CAS  Google Scholar 

  52. Han TH, Brimacombe J, Lee EJ, Yang HS. The laryngeal mask airway is effective (and probably safe) in selected healthy parturients for elective cesarean section: a prospective study of 1067 cases. Can J Anesth 2001;48:1117–21.

    Article  PubMed  CAS  Google Scholar 

  53. Dahan A, Teppema LJ. Influence of anaesthesia and analgesia on the control of breathing. Br J Anaesth 2003;91:40–9.

    Article  PubMed  CAS  Google Scholar 

  54. Lumb AB. Nunn's Applied Respiratory Physiology. 6th ed. Philadelphia: Elsevier, 2005:297–326.

    Google Scholar 

  55. Carli F, Mayo N, Klubien K, Schricker T, Trudel J, Belliveau P. Epidural analgesia enhances functional exercise capacity and health-related quality of life after colonic surgery. Anesthesiology 2002;97:540–9.

    Article  PubMed  Google Scholar 

  56. Sarton E, Teppema L, Dahan A. Sex differences in morphine-induced ventilatory depression reside within the peripheral chemoreflex loop. Anesthesiology 1999;90:1329–38.

    Article  PubMed  CAS  Google Scholar 

  57. Cohen SE, Labaille T, Benhamou D, Levron JC. Respiratory effects of epidural sufentanil after cesarean section. Anesth Analg 1992;74:677–82.

    PubMed  CAS  Google Scholar 

  58. Vicente KJ, Kada-Bekhaled K, Hillel G, Cassano A, Orser BA. Programming errors contribute to death from patient-controlled analgesia: case report and estimate of probability. Can J Anesth 2003:50:328–32.

    Article  PubMed  Google Scholar 

  59. Pan PH. Post cesarean delivery pain management: multimodal approach. Int J Obstet Anesth 2006;15:185–8.

    Article  PubMed  Google Scholar 

  60. Warren J, Sharma SK. Ventilatory support using bilevel positive airway pressure during neuraxial blockade in a patient with severe respiratory compromise. Anesth Analg 2006;102:910–1.

    Article  PubMed  Google Scholar 

  61. American Society of Anesthesiologists. Practice guidelines for the perioperative management of patients with obstructive sleep apnea. Anesthesiology 2006;104:1081–93.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Associate Professor of Anesthesiology and Obstetrics & Gynecology, University of Rochester Medical Center, 601 Elmwood Ave., Box 604, Rochester, NY 14642, USA

    Richard N. Wissler MD, PhD

Authors
  1. Richard N. Wissler MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

    Rights and permissions

    Reprints and permissions

    Copyright information

    © 2009 Humana Press, a part of Springer Science+Business Media, LLC

    About this chapter

    Cite this chapter

    Wissler, R.N. (2009). Anesthetic Considerations in Pregnant Patients with Pulmonary Disorders. In: Rosene-Montella, K., Bourjeily, G. (eds) Pulmonary Problems in Pregnancy. Respiratory Medicine. Humana Press. https://doi.org/10.1007/978-1-59745-445-2_8

    Download citation

    • DOI: https://doi.org/10.1007/978-1-59745-445-2_8

    • Published:

    • Publisher Name: Humana Press

    • Print ISBN: 978-1-934115-12-1

    • Online ISBN: 978-1-59745-445-2

    • eBook Packages: MedicineMedicine (R0)

    Publish with us

    Policies and ethics

    Search

    Navigation