AIRWAY ASSESSMENT FOR ANTICIPATION OF DIFFICULT INTUBATION: A DOUBLE BLIND COMPARATIVE STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2016, Vol 5, Issue 40
Abstract
BACKGROUND AND AIMS In this era of high technology, we still face an ageless problem in anaesthesia – the difficult airway. In 1997, Smarajith Sur Roy of India introduced a new airway index to predict difficult intubation. Aim of the study is to compare the new airway index with modified Mallampati classification and also with Cormack and Lehane grading for predicting intubation difficulty. MATERIALS AND METHODS The study was conducted on 200 patients undergoing various surgeries at a Government Medical College Hospital. Patients between the age group of 15 to 50 years and belonging to American Society of Anaesthesiologist Grade 1 or 2 were selected. Patients were graded using Modified Mallampati classification. Then in hyperextended neck, the distance between the angle of mandible and the midpoint of Symphysis menti (Variable A) and the distance between the symphysis menti and the thyroid notch (Variable B) were taken in centimetres and A/B ratio calculated. This ratio is the New Airway Index. After premedication and induction of anaesthesia, laryngoscopy was done, Cormack and Lehane grade noted and intubation difficulty assessed. The predictive value of the new airway index was compared against modified Mallampati classification as well as Cormack and Lehane grading and statistical significance assessed. RESULTS The observations made on the calculation of the new airway index were, 1. When the airway index was 1, the intubation was very easy, irrespective of the findings of Mallampati classification and Cormack and Lehane Grade was 1; 2. When the index was 1 to 1.399, the intubation was easier and the laryngoscopic findings were of Cormack and Lehane Grade II; 3. When the index was 1.4 or more, the intubation was difficult and they belonged to Cormack and Lehane Grade III. The predictability was also statistically very significant when compared with modified Mallampati classification (p<0.001 – Chi square test - test for single proportion). The success rate of the new airway index was also high when compared with Cormack and Lehane grading. CONCLUSION This study confirms the efficacy of the new airway index in predicting difficult intubation.
Authors and Affiliations
Ushakumary , Radha Raghavan, Bindu Veetil
Keywords
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- EP ID EP159610
- DOI 10.14260/jemds/2016/575
- Views 78
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