scholarly journals Relationship of neck circumference and difficult endotracheal intubation in obese patients

2017 ◽  
Vol 4 (2) ◽  
pp. 3-9
Author(s):  
Amit Kumar Karna ◽  
Khalid Bashir
Keyword(s):  
Endotracheal Intubation ◽  
Difficult Intubation ◽  
Pearson Correlation ◽  
Anesthetic Management ◽  
Cricoid Cartilage ◽  
Neck Circumference ◽  
Obese Patients ◽  
Patient Identification ◽  
Intubation Difficulty ◽  
Difficulty Scale

Background and Objectives: Patient identification with difficult intubation is important in planning anesthetic management and one major factor for difficult intubation in t he obese patients is large neck circumference. The need for prediction of a potentially difficult airway received great importance as it plays a significant role in reducing morbidity and mortality. Therefore, this study was done to glimpse the effect of neck circumference on endotracheal intubation and to determine the frequency of difficult intubation.Material and Methods: The study was cross sectional descriptive study and convenient sampling technique was used. Seventy patients of age between 19-50 years of both sexes were enrolled. Neck circumference was measured at the level of cricoid cartilage along with other airway assessments. Direct laryngoscopy was done and checked whether it is difficult one or easy using Intubation difficulty scale. Data were entered and analyzed by using statistical software SPSS version 15.0. Results: Mean BMI was noted as 33.02±2.30 kg/m2 and the mean neck circumference was 43.64±2.30 cm. Difficult intubation was observed in 23 (32.86%) patients with mean neck circumference of 45.44±1.88 cm and normal intubation observed in 47(67.14%) patients with mean neck circumference of 42.77±1.98 cm. Linear correlation was found between the neck circumference and Intubation Difficulty Scale score with value of Pearson correlation=0.617 .Conclusion: Neck circumference of patient was found to have significant effects on difficult intubation. Frequency of difficult intubation was found in almost one third of obese patients with increasing neck circumference.Janaki Medical College Journal of Medical Sciences (2016) Vol. 4 (2): 3-9 

scholarly journals Comparison of Incidence of Difficult Intubation between Obese and Nonobese Patients, and Comparison of Three Predictors of Difficult Intubation in Obese Patients

2016 ◽  
Vol 1 (2) ◽  
pp. 41-44
Author(s):  
Johann Mathew
Keyword(s):  
Tracheal Intubation ◽  
Difficult Intubation ◽  
Mouth Opening ◽  
Difficult Tracheal Intubation ◽  
Neck Circumference ◽  
Obese Patients ◽  
Chi Square ◽  
Neck Extension ◽  
Difficulty Scale ◽  
Nonobese Patients

ABSTRACT Background Anticipating a difficult airway is of prime importance to an anesthesiologist. Data available are inconclusive to say that tracheal intubation is more difficult in the obese. The deficiency occurring with individual factors can be avoided by adopting multiple airway assessment factors. In this study, we aim to compare the incidence of difficult intubation between obese and nonobese patients and compare three predictors of difficult intubation. Study design Prospective observational study. Materials and methods About 250 patients were assigned to two groups, obese and nonobese based on their body mass index. Preoperatively, neck circumference (NC), mouth opening, thyromental distance (TMD), neck extension, NC/TM ratio, Mallampati classification (MPC), and Wilson score (WS) were calculated. Difficulty of intubation was assessed using the intubation difficulty scale (IDS). All tracheal intubations were performed by anesthetists with more than 2 years of experience. Statistical analysis used Data analysis was done with the help of Statistical Package for the Social Sciences (SPSS) version 15, MedCalc version 11, and Epi data software. Qualitative data are presented with the help of frequency and percentage table, and association among various study parameters is done with chi-square test. Results The incidence of difficult intubation determined by the IDS (≥5) was more frequent in the obese group (88.6% in obese vs 11.4% in nonobese). Of the three variables, WS was found to be statistically significant (p < 0.005). Neck circumference to thyromental ratio is a new predictor for difficult tracheal intubation (DTI). But an NC/TM ratio of ≥5 gives high false positive for our population. How to cite this article Mathew J, Gvalani SK. Comparison of Incidence of Difficult Intubation between Obese and Nonobese Patients, and Comparison of Three Predictors of Difficult Intubation in Obese Patients. Res Inno in Anesth 2016;1(2):41-44.

scholarly journals Comparison of Upper Lip Bite Test with Modified Mallampati Score in Predicting Difficult Intubation

2022 ◽  
Vol 7 (1) ◽  
pp. 1-8
Author(s):  
Monish Thomas ◽  
Nichelle M. Saldanha
Keyword(s):  
Difficult Airway ◽  
Endotracheal Intubation ◽  
Difficult Intubation ◽  
Anaesthetic Management ◽  
Class Iii ◽  
Upper Lip ◽  
Intubation Difficulty ◽  
Mallampati Score ◽  
Difficulty Scale ◽  
A Prospective Study

Background and Aims: Identifying a patient with a difficult airway is important in planning anaesthetic management so that endotracheal intubation can be achieved safely. This study aims to compare modified Mallampati score with Upper Lip Bite Test to predict difficult intubation using intubation difficulty scale. Materials and methods: A prospective study was carried on 104 patients, both sexes aged between 18 to 60 years scheduled for elective surgeries under general anaesthesia fulfilling inclusion and exclusion criteria. Patient airway was evaluated by MMT and ULBT preoperatively. Predictors of difficult endotracheal intubation were assigned to MMT class III and IV, ULBT class III. After premedication and induction laryngoscopy was performed. After successful intubation Intubation difficulty score was noted down based on the sum of seven assessing parameters. A score >5 was considered difficult intubation. Results: The incidence of difficult intubation in the study was 10.6% (i.e. 11 out of 104 patients). In this study ULBT had a higher sensitivity (90.9% v/s 18.20%), specificity (95.7% v/s 75.3%) PPV (71.4% v/s 8%) and NPV (98.9% v/s 88.6%) than that of MMT Conclusion: Upper lip bite test is better at predicting difficult intubation with higher accuracy when compared to Modified Mallampati test. Both the tests are good predictors of easy intubation. Keywords: Upper Lip Bite Test (ULBT), Modified Mallampati test (MMT), Intubation Difficulty scale (IDS), airway assessment. Difficult intubation prediction, Difficult airway

scholarly journals Neck circumference to thyromental distance ratio: Is a reliable predictor of difficult intubation in obese patients?

2019 ◽  
Vol 6 (1) ◽  
pp. 152-156
Author(s):  
Vrishali R. Ankalwar ◽  
◽  
Manish Patel ◽  
Naresh G. Tirpude ◽  
◽  
...  
Keyword(s):  
Difficult Intubation ◽  
Neck Circumference ◽  
Obese Patients ◽  
Distance Ratio ◽  
Reliable Predictor

scholarly journals Comparison of Laryngoscopic Views between C-MAC™ and Conventional Laryngoscopy in Patients with Multiple Preoperative Prognostic Criteria of Difficult Intubation. An Observational Cross-Sectional Study

Medicina ◽  
2019 ◽  
Vol 55 (12) ◽  
pp. 760
Author(s):  
Aikaterini Amaniti ◽  
Panagiota Papakonstantinou ◽  
Dimitrios Gkinas ◽  
Ioannis Dalakakis ◽  
Evangelia Papapostolou ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Difficult Intubation ◽  
Elective Surgery ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Cross Sectional Study ◽  
Laryngoscopic View ◽  
Cross Sectional ◽  
Intubation Difficulty ◽  
Difficulty Scale

Background and Objectives: Video laryngoscopy has been proven useful under difficult airway scenarios, but it is unclear whether anticipated improvement of visualization is related to specific difficult intubation prognostic factors. The present study evaluated the change in laryngoscopic view between conventional and C-MAC® laryngoscopy and the presence of multiple difficult intubation risk factors. Materials and Methods: Patients scheduled for elective surgery with >2 difficult intubation factors, (Mallampati, thyromental distance (TMD), interinscisor gap, buck teeth, upper lip bite test, cervical motility, body mass index (BMI)) were eligible. Patients underwent direct laryngoscopy (DL) followed by C-MAC™ laryngoscopy (VL) and intubation. Change of view between DL and VL, time for best view, intubation difficulty scale (IDS) and correlation between prognostic factors, laryngoscopic view improvement, and IDS were measured. Results: One-hundred and seventy-six patients completed the study. VL lead to fewer Cormarck–Lehane (C/L) III-IV, compared to DL (13.6% versus 54.6%, p < 0.001). The time to best view was also shorter (VL: 10.82 s, DL: 12.08 s, p = 0.19). Mallampati III-IV and TMD ≤ 6 cm were related to improvement of C/L between DL and VL. Logistic regression showed these two factors to be a significant risk factor of the glottis view change (p = 0.006, AUC-ROC = 0.57, 95% CI: 0.47–0.66). 175/176 patients were intubated with VL. 108/176 were graded as 0 < IDS ≤ 5 and 12/176 as IDS > 5. IDS was only correlated to the VL view (p < 0.0001). Conclusion: VL improved laryngoscopic view in patients with multiple factors of difficult intubation. Mallampati and TMD were related to the improved view. However, intubation difficulty was only related to the VL view and not to prognostic factors.

scholarly journals Neck Circumference and Mallampati Classification

2017 ◽  
Author(s):  
Patrick Brennan
Keyword(s):  
Rhode Island ◽  
Difficult Intubation ◽  
Objective Assessment ◽  
Neck Circumference ◽  
Institutional Review Board ◽  
Anesthesia Practice ◽  
Intubation Difficulty ◽  
Institutional Review ◽  
Personal Experiences ◽  
Class 1

Difficult and failed intubations contribute to morbidly and mortality in anesthesia practice. Mallampati is one of the most widely used airway assessments but research shows it is highly variable in its ability to predict difficult intubation. Neck circumference is an objective assessment not commonly used, but has been shown to assess the degree of difficulty with intubation. Following Institutional Review Board (IRB) approval from both Charter Care and Rhode Island College, utilizing a descriptive design, 23 subjects had their neck circumference measured and Mallampati class assessed. The results revealed a relationship between increased neck circumference and Mallampati classification. The average neck circumference of the 23 subjects was 40.35 cm with an average Mallampati class of 2.54. The average neck circumference for Mallampati class 1 was 39.3 cm versus 42.8 cm for Mallampati class 4. Planning for a difficult airway and the assessments to use are highly variable. Practitioners pull from personal experiences as well as their training when it comes to how they provide care. Research has found that neck circumference is an objective assessment that correlates to difficult intubations. Mallampati is one of the standard airway assessments despite research showing that it does not accurately predict intubation difficulty. However, additional research is needed to understand the role neck circumference plays in everyday practice.

There is a new scale for difficult intubation in obese patients undergoing elective surgery-The neck circumference and other airway assessment test

2018 ◽  
Vol 23 ◽  
pp. 31
Author(s):  
Nicoleta Alice Dragoescu ◽  
Andreea Doriana Stanculescu ◽  
Alin Ionut Patru ◽  
Anca Lidia Vilcea ◽  
Andreea Badea ◽  
...  
Keyword(s):  
Difficult Intubation ◽  
Elective Surgery ◽  
Neck Circumference ◽  
Obese Patients ◽  
Airway Assessment

A validation study of the intubation difficulty scale for obese patients

2016 ◽  
Vol 33 ◽  
pp. 86-91 ◽  
Author(s):  
Arunotai Siriussawakul ◽  
Panita Limpawattana
Keyword(s):  
Validation Study ◽  
Obese Patients ◽  
Intubation Difficulty ◽  
Difficulty Scale

scholarly journals Neck circumference to thyromental distance ratio: a new predictor of difficult intubation in obese patients

2011 ◽  
Vol 106 (5) ◽  
pp. 743-748 ◽  
Author(s):  
W.H. Kim ◽  
H.J. Ahn ◽  
C.J. Lee ◽  
B.S. Shin ◽  
J.S. Ko ◽  
...  
Keyword(s):  
Difficult Intubation ◽  
Neck Circumference ◽  
Obese Patients ◽  
Distance Ratio
Sign in / Sign up

Export Citation Format

Share Document