General Anesthesia with the Use of SUPREME Laryngeal Mask Airway for Emergency Cesarean delivery: A Retrospective Analysis of 1039 Parturients.

In comparison to elective cesarean delivery, emergency cesarean delivery under endotracheal intubation is associated with higher risk of life-threatening airway problems. In this retrospective study, we evaluate the efficacy and feasibility of using SUPREME laryngeal mask airway (SLMA) in emergency cesarean delivery under general anesthesia (GA). The study included a total of 1039 paturients undergoing emergency cesarean delivery under GA with SLMA from January 2015 to December 2015 at Quanzhou Children's and Women's Hospital. Outcome measures included incidence of the adverse events related to using SLMA, maternal mortality, and neonatal outcomes. Briefly, no aspiration or regurgitation was noticed; the first attempt was successful in all but 2 subjects, both because of incorrect location, one was detected by decreasing oxygenation and the other by high airway pressure, the second attempt was successful in both cases. No subject was switched to endotracheal intubation. No laryngospasm or bronchospasm was detected. No maternal death occurred. There were 1139 neonates (including 944 single birth, 92 twins, 3 triplets) in this study, 5-min Apgar score was 7-10 in 1092 (96.72%) neonates. Thirty-seven (3.28%) neonates received endotracheal intubation. In conclusion, this retrospective study showed that the SLMA was used successfully in 1039 patients undergoing emergent cesarean delivery without any major complications. Vigilant attention by attending anesthesiologists is warranted.