PREDICTION OF DIFFICULT INTUBATION

The incidence of a difficult laryngoscopy or intubation varies from 1. 5% to 13%, and failed intubation has been identified as one of the ana esthesia-related causes of death or permanent brain damage. Problems i n the airway management can be predicted based on previous anaesthesia records, the medical history of the patient and a physical examinatio n. Several radiological measurements have been reported to be associat ed with a difficult intubation. The sensitivities of the commonly used bedside tests i.e. the Mallampati classification and the thyromental distance have been reported to be from 42% to 81%, and from 62% to 91% , respectively. The figures for the specificity have varied from 66% t o 84% and from 25% to 82%, respectively. The other subjective assessme nts and objective measurements employed for the prediction of a diffic ult intubation reach comparable sensitivities and specificities. Evide ntly, the positive predictive value is improved, if combinations of te sts are used. (C) Acta Anesthesiol Scandinavica 40 (1996).