General anesthesia: the breathing tube and the stomach
Two specific risks that make obstetric general anesthesia harder.
Difficult or failed intubation. Pregnancy swells the airway tissues. In a literature review, failed intubation occurred in about 2.3 per 1,000 general anesthetics for cesarean, roughly 1 in 443. In a multicenter analysis of 14,748 general anesthetics for cesarean, difficult intubation occurred in about 1 in 49 and failed intubation in about 1 in 808.
Aspiration. Stomach contents entering the lungs. Across 48,609 cesareans, aspiration occurred in about 1 in 11,345 under general anesthesia and 1 in 25,929 under regional anesthesia. This is why you are asked not to eat before a planned cesarean.
Where this comes from:
296. Kinsella SM, Winton AL, Mushambi MC, Ramaswamy K, Swales H, Quinn AC, et al. Failed tracheal intubation during obstetric general anaesthesia: a literature review. Int J Obstet Anesth. 2015;24(4):356-374.
297. Reale SC, Bauer ME, Klumpner TT, Aziz MF, Fields KG, Hurwitz R, et al. Frequency and risk factors for difficult intubation in women undergoing general anesthesia for cesarean delivery: a multicenter retrospective cohort analysis. Anesthesiology. 2022;136(5):697-708.
298. Binyamin Y, Orbach-Zinger S, Ioscovich A, et al. Incidence and clinical impact of aspiration during cesarean delivery: a multi-center retrospective study. Anaesth Crit Care Pain Med. 2024;43(2):101347.
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This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you. If you are worried about a symptom now, see urgent warning signs.