Predictability of difficult laryngoscopy in patients with long‐term diabetes mellitus

Abstract

The laryngoscopic conditions of 62 diabetic patients who underwent renal transplantation or vitrectomy were studied. Anaesthesia was induced with fentanyl and a sleep dose of thiopentone. Conditions for direct laryngoscopy after 0.1 mg/kg vecuronium were scored from 0 to 3 (easy-very difficult). All patients gave their palm prints after operation which were scored: 0, phalangeal areas completely visible; 1, phalangeal areas partly visible; 2, phalangeal areas hardly visible; 3, only fingertips printed. The incidence of difficult laryngoscopy was 31%. The higher the scores in the palm test, the more difficult was the laryngoscopy. The correlation coefficient between these two factors was r = 0.6 (p less than 0.001). Our study shows that joint rigidity possibly caused by tissue glycosylation may also involve laryngeal and cervical areas resulting in a strenuous laryngoscopy. A defective palm print is a warning sign for difficult laryngoscopy.