Procedures use by French anesthetists in cases of difficult intubation and the impact of a conference of experts

To analyse the management of difficult intubation (DI) by French anaesthetists and the impact of the French experts' conference (EC) on this topic. Prospective, comparative, before/after study by questionnaire carried out in Aquitaine, Provence-Alpes-Côte d'Azur and Alsace-Lorraine. A questionnaire on demographical data, detection of DI, management techniques and desiderata for continuing education on DI, was sent three months before the publication of the EC to 100 randomly selected anaesthetists, in each region (group PRE). Three months after the diffusion of the EC, the questionnaire completed by a survey on the impact of the EC was sent to 100 other randomly selected anaesthetists in each region (group POST). In the latter group, anaesthetists who considered the EC were compared to those who did not. The participation rate was 91% for the group PRE and 79% for the group POST respectively. Both groups were not significantly different for age, gender, position and seniority. Most used techniques that included blind nasal intubation (84%), intubation through laryngeal mask (82%), and intubation with fibrescope (53%). Demands for additional training were for translaryngeal ventilation (68%), intubation with fibrescope (64%), retrograde intubation (52%), and intubation through a laryngeal mask (46%). The EC was known by 71% of anaesthetists. In this group, the EC improved the assessment rate of the three recommended predictive criteria for DI from 12 to 28% (P < 0.02), but neither the management policy, nor the desiderata for additional training. Currently, the search of predictive indicators for DI is not systematically applied. The EC has only slightly modified the practice patterns. The need for additional training is important.