Video laryngoscopy for obstetric airway management: A narrative review

Abstract

The obstetric population has an increased risk of difficult airways due to changes, with a mortality rate of 1 death per 90 failed intubations. Recently guidelines for difficult airway management have recognized and recommended video laryngoscopy devices in difficult airway cases. Although there has been a substantial number of publications on video laryngoscopy, there is a lack of literature to help establish its use for managing obstetric airways. Therefore, we conducted a narrative review to evaluate the performance and efficacy of video laryngoscopy in obstetric patients. A literature review was performed on papers published until November 2024, studying adult patients who underwent obstetric procedures under general anesthesia. Improved glottis visualization, increased success rate in patients with predicted difficult airways, and rescue of a failed direct laryngoscopy attempt are advantages of video laryngoscopy. There are conflicting results regarding video laryngoscopy being superior to direct laryngoscopy regarding first-attempt success and time to intubation. Additionally, we discussed different types of video laryngoscope blades and video laryngoscopy with training in the obstetric population. Our review's findings are consistent with the current guidelines that recommend video laryngoscopes should be available for every obstetric general anesthesia, summed to the need for larger studies in this population.