International journal of obstetric anesthesia · 2025
Pulmonary complications following postpartum tubal ligation with laryngeal mask vs. endotracheal intubation: a retrospective cohort study (2012-2024).
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Lindo A F, Hincapié-Ayala D, Alzate-Ricaurte S, Rodríguez M, Cruz-Suárez G A, Vasco-Ramírez M
Аннотация
BACKGROUND: General anesthesia with endotracheal intubation is standard in obstetric patients due to the risk of aspiration. However, endotracheal intubation carries procedure-related risks, prompting interest in laryngeal masks as alternative or rescue devices. Evidence supporting their use in postpartum tubal ligation remains limited.
METHODS: A retrospective cohort study was conducted at a high-risk obstetric center, including patients who underwent postpartum tubal ligation between 2012 and 2024. Patients were grouped according to the airway device used: laryngeal mask or endotracheal intubation, including those who required conversion. The primary outcome was the incidence of respiratory complications, including pneumonia, respiratory failure, anesthesia-related reactions, and other significant adverse events, within seven postoperative days. Secondary analyses included demographic and obstetric characteristics.
RESULTS: There were 1,095 cases performed under general anesthesia, 503 (46 %) received endotracheal intubation and 592 (54 %) supra-glottic airway. No respiratory complications were observed in either group; Poisson-based confidence intervals confirmed that the upper bound of incidence remained < 1 %. Patients with supra-glottic airway were more likely to be ASA I (34 % vs. 21 %), and 2.6 % had conversion to endotracheal intubation. Patients with endotracheal intubation had a higher median body mass index (29.7 vs. 29.2 kg/m2, P = 0.027).
CONCLUSION: In this retrospective analysis of postpartum tubal ligation under general anesthesia, there were no respiratory complications with either airway device. Supraglottic airway devices appear to be a safe alternative in carefully selected patients.
METHODS: A retrospective cohort study was conducted at a high-risk obstetric center, including patients who underwent postpartum tubal ligation between 2012 and 2024. Patients were grouped according to the airway device used: laryngeal mask or endotracheal intubation, including those who required conversion. The primary outcome was the incidence of respiratory complications, including pneumonia, respiratory failure, anesthesia-related reactions, and other significant adverse events, within seven postoperative days. Secondary analyses included demographic and obstetric characteristics.
RESULTS: There were 1,095 cases performed under general anesthesia, 503 (46 %) received endotracheal intubation and 592 (54 %) supra-glottic airway. No respiratory complications were observed in either group; Poisson-based confidence intervals confirmed that the upper bound of incidence remained < 1 %. Patients with supra-glottic airway were more likely to be ASA I (34 % vs. 21 %), and 2.6 % had conversion to endotracheal intubation. Patients with endotracheal intubation had a higher median body mass index (29.7 vs. 29.2 kg/m2, P = 0.027).
CONCLUSION: In this retrospective analysis of postpartum tubal ligation under general anesthesia, there were no respiratory complications with either airway device. Supraglottic airway devices appear to be a safe alternative in carefully selected patients.