Prediction and prevalence of difficult intubation in Nepalese population
Keywords:
Difficult laryngoscopy, Nepal, Prediction, Prevalence.Abstract
Background: Prevalence of difficult intubation is estimated as 3-18% during routine anesthesia. There are various bedside tests to predict the difficult intubation, like Mallampati test, Thyromental distance, Sternomental distance and mouth opening. However, the prevalence and prediction in Nepalese population is still not estimated. So this study is to see the prevalence and to compare the efficacy of airway parameters to predict the difficult intubation in Nepalese population.
Methods: A prospective study was done to estimate the prevalence and prediction of difficult intubation in Nepalese population. During six months period, 182 patients who were undergoing routine surgery under General anesthesia were included in the study. Mallampati grading, thyromental distance, mouth opening and sternomental distance were recorded in preoperative assessment. Cormack and Lehane grading were done during intubation and Grade I and II are considered as easy intubation/laryngoscopy and III and IV are considered as difficult intubation.
Results: The prevalence of difficult intubation was 4.9%. Sensitivity of different tests were as follows; Mallampati test - 55%, thyromental distance - 33%, mouth opening - 22% and sternomental distance - 11%. The Specificity of the test as Mallampati test - 98%, thyromental distance - 89%, mouth opening - 96% and sternomental distance - 97%. So the Mallampati test is more sensitive and specific among the tests done.
Conclusion: This prospective study shows that the prevalence of difficult intubation is not different in Nepalese population and the bedside predictors also are good tests that could be continued in our population.
References
2. Rose DK, Cohen MM. The airway problems and prediction in 18500 patients. Can J Anesth 1994;41:372-83.
3. Cormack RS, Lehane J. Difficult tracheal intubation in obstetrics. Anaesthesia 1984;39:1105-11.
4. Samsoon GLT, Young JRB. Difficult tracheal intubation: a retrospective study. Anaesthesia 1987;42:487-90.
5. Wong SH, Hung CT. Prevalence and prediction of difficult intubation in Chinese women. Anesthesia and Intensive care 1999;27:49-52.
6. Savva D. Prediction of difficult tracheal intubation. Br J anaesth 1994;73:149-53.
7. Gupta AK, Ommid M, Nengroo S, Naqash I, Mehata A. Predictors of difficult intubation: Study in Kashmiri Population. BJMP 2010:3:307.
8. Lee A, Lawrence TY, Gin T, Karmakar MK, Kee N. A systemic review (meta analysis) of the accuracy of the Mallampati test to predict the difficult airway. Anesth Analg 2006;102:1867-78.
9. Singha T, Wijama Z, Inoue T, Sakamoto A. Predicting difficult intubation in apparently normal patients. Anesthesiology 2005;103:429-37.
10. Bonjong K, Siriwan D, Kumkeaw S, Tanomsat M. The predictive value of height ratio and thyromental distance: four predictive test for difficult laryngoscopy. Anesth Analg 2005;101:1542-5.
11. Lavi R, Segal D, Ziser A. Predicting difficult airways using the Intubation difficulty scale: a study comparing obese and non obese patients. Journal of clinical anesthesia 2009;21:264-7.
12. Kim WH, Ahn HJ, Lee CJ, Shin BS, Ko JS, Choi SJ, Ryu SA. Neck circumference to thyromental distance ratio: new predictor of difficult intubation in obese patient. Br J Anesth 2011;10:1093.
13. el Ganzouri AR, Mc Carthy RJ, Tuman KJ, Tanck EN, Ivankovich AD. Preoperative Airway Assessment: Predictive Value of a Multivariate risk index. Anesth Analg 1996;82:1197-204.
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