The value of decision tree analysis in planning anaesthetic care in obstetrics

• Anaesthetic management of a joint hypermobility syndrome patient with a difficult airway is discussed.
• Management is reconsidered using decision tree analysis.
• The value of decision tree analysis in obstetric anaesthesia is discussed.

The use of decision tree analysis is discussed in the context of the anaesthetic and obstetric management of a young pregnant woman with joint hypermobility syndrome with a history of insensitivity to local anaesthesia and a previous difficult intubation due to a tongue tumour. The multidisciplinary clinical decision process resulted in the woman being delivered without complication by elective caesarean section under general anaesthesia after an awake fibreoptic intubation. The decision process used is reviewed and compared retrospectively to a decision tree analytical approach. The benefits and limitations of using decision tree analysis are reviewed and its application in obstetric anaesthesia is discussed.