Intubation orotrachéale : à partir de deux théâtres d'opérations extérieures, épidémiologie des intubations difficiles prévues et imprévues

Difficult Intubation (DI) to impossible Orotracheal Intubation (OTI) is a true issue; whether it is scheduled or not, in anesthesiology for a planned or an emergency surgery, or in intensive care, the epidemiology in the military environment on the field of operations (OPEX) is relatively unknown. Describe the OTI practices at the KaIa Medical and Surgical Hospital (Kabul, Afghanistan) and the N'Djamena Medical and Surgical Group (Chad) as well as define the available solutions to cope with DI situations. Prospective and descriptive study was based on surveys completed after the OTI of any patients, civilian and military, adults and children, in surgery or intensive care. Four hundred and forty-four OTI have been analysed. The OTI's indications were 79.1% for planned surgery, 17.3% for emergency surgery; 3.6% in intensive care. The DI's predictive criteria have been measured for 70.94% of the OTI, with at least one to the criteria was available in 18.41% of the cases. Thirty DI cases have been raised (6.8% of the OTI) including 22 in adult planned surgery. The partially rigid stylet was used 14 times (46.7% of DI cases), Eschmann stylet 9 times (30%), and Airtraq 2 times (7%). The risk factors associated with the DI in multivariate analysis were the location of OPEX (Chad) (OR 3.2) and the presence of at least one ID criteria (OR 5.09). Our study points out the low rate of ID < 7% due to demographic characteristics (young population in OPEX) and indications (mainly planned surgery). The partially rigid and Eschmann stylet and the Airtraq are the ideal alternative technics in OPEX.