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British Journal of Anaesthesia, 1991, Vol. 66, No. 1 38-44
© 1991 The Board of Management and Trustees of the British Journal of Anaesthesia

research-article

UNEXPECTED, DIFFICULT LARYNGOSCOPY: A PROSPECTIVE SURVEY IN ROUTINE GENERAL SURGERY

K. N. WILLIAMS, M.A., M.B., B.S., F.C.ANAES.*, F. CARLI, D.M.S., F.C.ANAES. and R. S. CORMACK, B.A., B.SC., B.M., B.CH., F.C.ANAES.

Department of Annesthetics, Northwick Park Hospital & Clinical Research Centre Harrow HA1 3UJ

*Present address, for correspondence: Department of Anaesthetics, Charing Cross Hospital, London W6 8RF.

A prospective study of unexpected, difficult laryngoscopy was carried out. During a 7-month period, all general surgery patients in whom the trachea was intubated were assessed; only those with obvious neck pathology were excluded. Ease or difficulty of laryngoscopy was graded by a standard method. There were no grade 4 cases and no failed intubations in a total of 1387 cases. There were significant differences in the results recorded by different individuals; this did not correlate with seniority or with the type of surgery. Four factors have been identified which help to explain these discrepancies. These findings are analysed in relation to the training of junior staff, with particular reference to obstetric anaesthesia.


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