Unexpected Difficult Intubation. Is it a Solvable Problem? Reflections for a Safe Approach

Approximately 230 million major surgical procedures are performed annually around the world as reported by The Lancet in the editorial ‘Surgical Outcomes and Opportunities’ [1]. In US everyday about 60,000 people have general anesthesia [2], in UK 2.9 million annually [3], Approximately 4% of tracheal intubations are unexpectedly difficult. In terms of numbers it is perhaps one of the most critical moments of the entire anesthetic procedure. Data reported in the literature also indicate that 30% of the incidents totally attributable to anesthesia are due to difficulties in airway management [4]. The scientific community has long focused on this problem by establishing study groups or by creating scientific societies dedicated to airway management. Industry has marketed dedicated devices as a result of constant advances in imaging technology. The most prestigious journals are aware of the importance of the issue and have provided more space for discussion and debate.