Prediction of Difficult Airway Among Pediatric and Adult Patients Scheduled for Ophthalmological Surgeries under General Anesthesia
Keywords:
Airway, Cormack-Lehane Grading, Laryngoscopy, Mallampati score, PrevalenceAbstract
Objective: To evaluate the sensitivity and specificity of bedside tests for prediction of difficult airway scheduled for ophthalmological surgeries under general anesthesia.
Methods: This prospective study was carried out at Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan from March 2020 to October 2020. All pediatric and adult patients with American society of anesthesiologist grade I to IV undergoing elective ophthalmological surgeries under general anesthesia were consecutively enrolled. Mallampati grading, sternomental, thyromental distance, and mouth opening used as the predictors tools whereas Cormack and Lehane (CL) classification validated with on table laryngoscopy. Grade I and II were assigned as easy laryngoscopy whereas grade III and IV were declared as difficult intubation.
Results: Of 232 patients, difficult intubation was observed in 36 (15.5%). Sensitivity and specificity of thyromental distance was 80.5% and 99.4% respectively. Whereas sensitivity of mouth opening was 66.6% and specificity was 99.4%. In case of sternomental distance, sensitivity and specificity corresponded to 61.6% and 100% respectively. The sensitivity and specificity of Modified Mallampati Grading was 97.2% and 96.4% respectively. The relationship between CL grading and MMC showed that all the patients with CL grade I had Malampati grade I, i.e., 28 (100%), while all patients with CL grade IV had Malampati grade IV, i.e., 7 (100%).
Conclusion: Bedside tests prove to be useful parameters for prediction of difficult airway at pre-anesthesia assessment among which Mallampati test is most sensitive and specific, subsequently ensuring availability of difficult intubation equipment, which is a focus of concern in third world countries.
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