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Acta Anaesthesiol Scand. 2001 Mar;45(3):327-32.

A survey of tracheal intubation difficulty in the operating room: a prospective observational study.

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Department of Anesthesiology-SAMU 93, Avicenne University Hospital, University Paris XIII, Bobigny, France.



The purpose of this study is to describe all degrees of endotracheal intubation difficulty among patients attended by eight anesthesiologists during routine surgery over a six-month period. Airway characteristics were routinely assessed preoperatively, according to the anesthesiologists' usual practice.


Difficult tracheal intubation was evaluated by the Intubation Difficulty Scale (IDS), a quantitative score based on seven variables. An IDS value of 0 is consistent with a procedure without difficulty, and an IDS > 5 with a procedure involving moderate to major difficulty.


For 1171 patients undergoing tracheal intubation, IDS was 0 in 55%, and greater than 5 in 8% of cases. External laryngeal pressure, repositioning the patient and added use of a stylet were the most frequent methods chosen to facilitate tracheal intubation.


There was a high incidence (37%) of minor difficulties encountered during routine surgery.

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