Preoperative Predictors of Difficult Intubation

Alaubaidi, Rasha. S.; Hussein, Maitham. M.

doi:10.52573/ipmj.2021.174073

	Preoperative Predictors of Difficult Intubation
Iraqi Postgraduate Medical Journal
Article 10, Volume 21, Issue 1, 2022, Pages 70-75 PDF (197.83 K)
Document Type: Research Paper
DOI: 10.52573/ipmj.2021.174073
Authors
Rasha. S. Alaubaidi; Maitham. M. Hussein
Anesthesiology Dept. Baghdad Teaching Hospital, Baghdad, Iraq
Abstract
BACKGROUND Because a difficult intubation may occur unexpectedly, airway examination is the most critical component of anesthetic practice. Prior to surgery, all of the patients' airway parameters were examined. Parameters included age, body mass index, neck circumference, head movement, mouth opening space, mandibular length, sternomental and thyromental distance, dental deformities, as well as a history of medical, surgical, and difficult intubation were all taken into consideration with thyroid related factors (tracheal deviation and retrosternal goiter).In respect to the preoperative parameters, all patients were categorized intraoperative, using the Cormack and Lehane laryngoscopic View. Clinical data from each test was collected, and analyzed to establish its relevance, positive predictive value, and negative predictive value. AIM OF THIS STUDY: The effectiveness of airway characteristics in predicting difficult intubation was compared in a prospective research to enhance airway management especially in those with difficult intubation to prevent post operative morbidity and mortality airways complication. METHODS: From January 1 to June 30, 2021, a cross-sectional study was conducted on 72 patients their age range between 25-70 years old both genders .They were admitted to the Baghdad Medical City Teaching Hospital for a variety of elective procedures. The patients were collected and examined preoperatively involving the age, gender, weight and length with special evaluation of upper airway assessment including neck movement is assessed by extending the head at the atlanto-occipital joint and performing the cervical flexion-rotation test manually. RESULT: The findings revealed a 13.9 percent incidence of problematic intubation among the 72 patients studied. Higher prevalence of difficult intubation noticed significantly among patients with past medical history (44.4%) , patients with abnormal dentation (36.4%) also Prevalence of difficult intubation was increasing with aging to reach (30% )in patients aged ≥ 50 years. Difficult neck movement before surgery was significantly associated with difficult intubation (P= 0.001). In this study, means of mouth opening and sternomental distance were significantly (P < 0.05) lower in patients with difficult intubation than those with easy intubation. No statistically significant correlation (P ≥ 0.05) % between Cormack-Lehane grading system and any of the other characteristic. CONCLUSION: In this study we discovered that patients with a positive past medical history like history of diabetes mellitus and those with abnormal dentation are highly significant preoperative Intubation difficulty predictors. The risk of difficult intubation also increases in patients over the age of 50, difficult neck movement, and in patients with limited mouth opening, as well as short sternomental distance.
Keywords
difficult intubation; difficult laryngoscopy; patent airway; airway management

References
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