Acromio Axillo Suprasternal Notch Index a New Method of Predicting Difficult Intubation: Prospective Observational Study
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 10
Abstract
Background: The fundamental responsibility of anesthetist is to maintain the airway and provide adequate oxygenation. Failure to do this will lead to hazardous complication. So identification of difficult airway is important during pre operative evaluation. Difficult intubation can be predicted by modified mallampati test (MMP), interincisor distance, thyromental distance (TMD), sternomental distance, upper lip bite test and hyomental distance ratio, but no single factor reliably predicts difficult intubation. AASI, a relatively new test, based on surface land mark, has been suggested to reliably predict difficult visualization of larynx. Methods: A total of 250 adult patients, of either sex, aged 18 65 years, belonging to ASA class 1, 2 and 3 who were candidates undergoing elective surgery under general anaesthesia requiring tracheal intubation participated in a prospective, comparative, observational study. Preoperative airway assessment was carried out with AASI, TMD and MMP. Sensitivity, specificity, positive predictive value, negative predictive value, odd’s ratio, positive likelihood ratio, negative likelihood ratio were calculated for MMP, TMD and AASI. Chisquare test was used to analyze data. P value of less than 0.05 was considered statistically significant. Results: The demographic data was normally distributed in terms of age, height, weight, bmi, and gender distribution. The sensitivity between MMP and TMD was statistically significant. There was no significant difference between the Specificity, positive predictive value & negative predictive value of MMP and TMD (p>0.05). There was no significant difference between the Sensitivity, Specificity, positive predictive value & negative predictive value of MMP and AASI. (p>0.05) There was significant difference in Sensitivity of TMD & AASI. But, there was no significant difference between the Specificity, Positive predictive value & Negative predictive value between TMD and AASI. Conclusion: Upon comparing AASI, MMP and TMD, AASI was found to be better only with regards to sensitivity no difference in any of the measured parameters in comparison to modified mallampati test. To conclude we would recommend further studies with larger sample size before validating or refuting the ASSI.
Authors and Affiliations
Girish K. N
Keywords
Related Articles
- EP ID EP548673
- DOI 10.21088/ijaa.2349.8471.51018.24
- Views 76
- Downloads 0
A Comparative Study between Continuous Epidural Infusion and Continuous Femoral Nerve Block for Post-Operative Pain Relief in Total Knee Replacement Surgeries
Background: Postoperative pain management in TKR is of imperative importance. Epidural analgesia though considered as a standard technique in postoperative pain management in TKR it was commonly associated with unwanted...
Comparison between Combined Sciatic-Fascia Iliaca Compartment Block and Unilateral Spinal Anesthesia for Unilateral Lower Limb Surgery: A Retrospective Study
Introduction: We aimed this study to evaluate the efficacy, quality and safety of combined sciatic and Fascia Iliaca Compartment Block with Unilateral Spinal Anaesthesia for selected lower limb surgeries. Materials & Me...
Evaluation of Pre-emptive Intramuscular Glycopyrrolate in Prevention of Spinal Anesthesia Induced Hypotension in Elective Cesarean Sections
Context: Spinal anesthesia induced hypotension in parturients undergoing Cesarean section can be detrimental to both foetus and mother. Prophylactic administration of vasopressors helps in preventing hypotension thereby...
Comparision of 0.5% Ropivacaine and 0.5% Bupivacaine for Supraclavicular Brachial Plexus Block in Upper Limb Surgeries
Introduction: Supraclavicular approach to brachial plexus block produces the most complete upper limb block as it blocks the brachial plexus at the level of the trunks formed by C5-T1 nerve roots.Ropivacaine is a pure S...
A Comparative Study of Dexmedetomidine HCL and Esmolol HCL for Attenuating Pressor Response to Laryngoscopy and Oral Endotracheal Intubation
Introduction: Laryngoscopy and intubation increases sympathetic activity resulting in tachycardia and hypertension which may cause myocardial ischemia, cardiac arrhythmias and cerebrovascular hemorrhage. We compared the...