WHAT IS THE RELATIONSHIP BETWEEN A GYNECOLOGIST/OBSTETRICIAN AND THE AIRWAY?/STO POVEZUJE GINEKOLOGA/OPSTETRICARA S DISNIM PUTOM?

Physiological changes in pregnancy as part of biohumoral and morphological changes (hyperemia, edema, hypersecretion) influence the possible problems in obstetric anesthesia. These changes by themselves, and particularly aggravated by acute or chronic gestational or non-gestational comorbidity, increase the risk of aspiration of gastric contents, failed intubation, esophageal intubation, inadequate ventilation, and respiratory failure. The types of premedication, anesthesia and techniques of anesthesia are evident from medical historiography. Almost obligatory promethazine and atropine was given intravenously either in the delivery room or on the operating table immediately before the induction of anesthesia in a dose of 0.5 mg in partuients of average body weight. Atropine has been a favorite premedicant for decades, given its pharmacological properties, especially its antisialogenic effect and absence of a depressant effect on the fetoplacental unit, but today it is rarely used. Nasal decongestants before surgery are not recommended but in cases of severe rhinitis, atropine, promethazine, or topical decongestants may be used. Key words: Airway; Obstetrics; Obstetric anesthesiology; High-risk parturient; Pregnancy Fizioloske promjene u trudnoci u sklopu biohumoralnih i morfoloskih promjena (hiperemija, edem, hipersekrecija) utjecu na mozebitne probleme u opstetrickoj anesteziji. Fizioloske promjene same po sebi, a osobito pogorsane akutnim ili kronicnim gestacijskim ili negestacijskim komorbiditetom, cimbenici su rizika za nastanak gastricne aspiracije, teske intubacije, ezofagusne intubacije, neadekvatne ventilacije i respiracijskih poremecaja. Vrste premedikacije, anestezija i tehnika anestezije razvidna su iz povijesti medicine. Tako su se prometazin i atropin obligatno rabili intravenski u radaonici ili operacijskoj dvorani neposredno prije uvoda u anesteziju u dozi od 0,5 mg atropina kod rodilja prosjecne tezine. Atropin je desetljecima bio omiljen monopremedikant s obzirom na njegova farmakoloska svojstva, napose antisijalogenog ucinka i manjak medikamentne depresije na fetoplacentarnu jedinicu, no danas se rijetko rabi. Nazalni dekongestivi prije operacije se ne preporucuju, no u slucajevima teskih oblika rinitisa, atropin, prometazin ili topikalni dekongestivi mogu se primijeniti. Kljucne rijeci: Disni put; Porodnistvo; Porodnicka anesteziologija; Visokorizicna rodilja; Trudnoca