COMPARISON OF UPPER LIP BITE TEST AND MODIFIED MALLAMPATI CLASSIFICATION IN PREDICTING DIFFICULT INTUBATION
Journal Title: IJSR-International Journal Of Scientific Research - Year 2019, Vol 8, Issue 3
Abstract
Introduction : Airway management is of prime importance to the Anaesthesiologist for securing the airway, tracheal intubation using direct laryngoscopy remains the method of choice in many cases. Difficult laryngoscopic endotracheal intubation still remains an important concern of anaesthesiologists. The incidence of difficult endotracheal intubation were reported to be between 1.5% to 13% among patients undergoing surgery. The present study was conducted with the primary aim to evaluate sensitivity, specificity, accuracy, negative predictive value and positive predictive value of Upper Lip Bite Test and Modified Mallampati Classification to predict difficult intubation in patients undergoing any elective surgery under general anesthesia. Material & Methods : A single-blind, Prospective Observational (Analytical) study was conducted in Krishna Institute of Medical Sciences, Hospital and Research Centre, Karad, Maharashtra after the approval from the institutional ethical committee. A sample size of 181 patients of both gender, between 20 and 50 years of age, belonging to ASA physical Status I-II scheduled to undergo elective surgery under general anaesthesia with endotracheal intubation were evaluated for both test before surgery after fulfilling the inclusion criteria. A senior Anaesthesiologists having minimum five years of experience in clinical anaesthesia who unaware of preoperative airway assessment, performed laryngoscopy and grading as per Cormack and Lehane's classification. Senstivity, specificity,accuracy, positive and negative predictive values of Upper lip bite test and Modified Mallampati Classification were calculated. Results: We compared various accuracy parameters of both the methods (MMT and ULBT), we observed that MMT (88.23% Vs. 76.47%) has got higher sensitivity, higher specificity of (89.02% Vs. 87.19%), higher positive predictive value (45.45% Vs. 38.23%) and higher negative predictive value (98.64% Vs. 97.27%) as compared to ULBT. Conclusion : In comparison with ULBT, MMT has got better predictive ability for difficult endotracheal intubation. MMT and ULBT appear to be better predictors for easy intubations rather than difficult intubations (high negative predictive value). Combination of MMT and ULBT has got better diagnostic accuracy as compared to MMT or ULBT alone.
Authors and Affiliations
Dr. Abhishek Kumar Singh, Dr. N. V. Kanase*, Dr. V. K. Dhulkhed
Keywords
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