Prediction of Difficult Intubation in Apparently Normal Patients by Combining Modified Mallampatti Test and Thyromental Distance
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2019, Vol 6, Issue 1
Abstract
Context: Difficult intubation is associated with serious complications, more so when there is failure of intubation. Inability to secure the airway during general anaesthesia remains one of the leading causes of morbidity and mortality worldwide. The principle goal of this study was to find the best predicting test in patients who are apparently normal by a combination of Modified Mallampatti test and Thyromental distance and comparing it with Cormack and Lehane Score. Aims: To use Mallampatti test & Thyromental distance test during pre-operative assessment to determine incidence of difficult laryngoscopy and intubation; To combine sensitivity and specificity of both the tests and determine, if the combination of both the tests increases the predictability of difficult intubation. Settings and Design: Prospective clinical study. Methods and Material: The preoperative airway assessment of Mallampatti grading & thyromental distance was done on 300 ASA grade 1 & 2 patients, aged between 18-60 yrs presenting for surgeries under general anesthesia. The preoperative Mallampatti test grading and the thyromental distance was compared with Cormack & Lehanelaryngoscopic grade. Statistical analysis used: Data was entered in to Microsoft Excel Worksheet and analyzed using SPSS (ver. 18) statistical package. In addition to sensitivity and specificity, the positive and negative predictive values were calculated. Results: The Mallampatti grade 3 & 4 were considered as predictors of difficult intubation 28 cases out of 300 patients (9.3%) of the study population belong to this group. Thyromental distance < 6 cm was considered as predictor of difficult intubation There were 17 cases out of 300 patients (5.7%) belonging to this group. When a combination of Mallampatti test and thyromental distance was used as a predictor of difficult intubation, there were 16 patients, which constituted 5.3% of the total cases. The incidence of difficult intubation is found to be 5%. Conclusions: The above result shows that the discriminative power is greater in combination of test than when used alone.
Authors and Affiliations
Kiran Nelamangala
Keywords
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- EP ID EP601133
- DOI 10.21088/ijaa.2349.8471.6119.38
- Views 107
- Downloads 0
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