A Study to Predict Difficult Intubation Using Simple Non-invasive test: A Prospective Observational Study
DOI:
https://doi.org/10.21276/tqb8rk75Keywords:
Airway Management, ULBT, HMD, TSD, TMD, ML & Cormack Lehane grading.Abstract
Background: Airway Management is prime importance to the anaesthesiologist of all the anaesthetic deaths 30 % to 40 % are attributed to the inability to manage a difficult airway. The various simple bedside predictors of difficult airway like Mallampati test, Upper lip bite test, Thyromental, Hyomental, Thyrosternal & Sternomental distances, mandibular length, Neck circumferences etc. are easy to perform with No extra cost or inconvenience to patients. Aim: To assess the predictability of Upper lip bite test, Hyomental distance, Thyromental distance, Thyrosternal distance & Mandibular length. Objective: 1) To find out the best predictor of difficult intubation amongst the Upper Lip Bite Test, Hyomental Distance, Thyromental Distance, Thyrosternal Distance & Mandibular Length on the basis of the test. Methods: This is a prospective observational study of 110 patients are randomly selected & age caring between 20 to 59 yrs both male and female are presented in anaesthesia of routine per anaesthetic check-up. After from mouth opening & mallampati test which are routinely done airway assessment included ULBT, HMD, TMD, TSD & ML will be done.
Results: After analysing study state that the age (P = 0.031) were significant , & sex (P = 0.213) ASA (P = 0.091) were not significant with difficult intubation on the basis of Cormack lehane grading. All these factors were applicant on next set of 110 patients to found sensitivity & specificity to be ULBT ( SE = 50.00%, SP =100.00%), HMD (SE = 10.00%, SP = 97.00%), TSD (SE = 0.00%, SP = 97.00%), ML (SE = 20.00%, SP = 97.00%) & TMD (SE = 70.00%, SP = 85.00%) respectively.
Conclusions: Thyromental distance is the most important sensitive factors predicting difficult intubation on the basis of cormack lehane grading in indian patients.
Downloads
References
Caplan RA, Posner KL, Ward RJ, Cheney FW. Adverse respiratory events in anaesthesia: a closed claims analysis. Anaesthesiology. 1990; 72: 828-33.
Khan ZH, Makarm J, Mohammadi M, Khan RH, Zandieh A. A comparison of the ULBT with Hyomental / Thyrosternal distances & Mandible length in predicting difficult intubation: A prospective study Journal of Anaesthesia 2011 Jan, 55(1) : 43.
Benumof JL, Schella MS. The importance of transtracheal Jet ventilation in the management of difficult airway. Anesthesiology 1989: 71 : 769-78.
Sunanda Gupta, KR Rajesh Sharma, Dimpel Jain.Airway assessment: Predictors of difficult airway. Indian Journal of Anaesthesia, Year 2005, Volume 49, Issue 4; p. 257.
Cormack RS, Lehane J. Difficult tracheal intubation in obstetrics. Anaesthesia 1984; 39(11):1105-11.
Khan ZH, Kashfi A, Ebrahimkhani E.: A comparison of the upper lip bite test (a simple new technique) with modified Mallampati classification in predicting difficulty in endotracheal intubation: a prospective blinded study. Anesth Analg 2003; 96: 595 –9.
Huh J, Shin HY, Kim SH, Yoon TK, Kim DK. Diagnostic predictor of difficult laryngoscopy: the Hyomental distance ratio. AnesthAnalg. 2009 Feb;108(2):544-8.
D. Cattano, E. Panicucci, A. Paolicchi, F. Forfori, F. Giunta, and C. Hagberg. Risk Factors Assessment of the Difficult Airway: An Italian Survey of 1956 Patients. AnesthAnalg 2004; 99:1774–9.
Vikas K. N. Deepak TS. Evaluation of Modified Cormack-Lehane Scoring System in Indian Population. AIMDR, Vol (3); Issue (1); 17-19.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 International Archives of BioMedical and Clinical Research
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors are required to sign and submit the completed “Copyright transfer Form” upon acceptance of publication of the paper. This is determined by a publishing agreement between the author and International Archives of Biomedical and Clinical Research. These rights might include the right to publish, communicate and distribute online. Author(s) retain the copyright of their work. International Archives of Biomedical and Clinical Research supports the need for authors to share, disseminate and maximize the impact of their research.
