Abstract

Dr. Bindu M., *Dr. Dhanesh Sukumaran and Dr. Ranju Sebastian

ABSTRACT

Background: Unanticipated difficult laryngoscopy and tracheal intubation always remain a primary concern for the anesthesiologist, as the failure to maintain a patent airway after the induction of general anesthesia is one of the most common causes of anesthesia-related morbidity and mortality. Because of potentially serious consequences of failed tracheal intubation, considerable attention has been focused on attempts to predict patients in whom laryngoscopy and intubation might be difficult and in this regard combination of different test and scores are developed, but none of them have proven to be totally reliable. Methods: We conducted a study evaluating the relationship between preoperative airway assessments like modified Mallampati, upper lip bite test and ratio of neck circumference to Thyromental distance with glottis exposure obtained during direct laryngoscopy in 250 patients. Results: The incidence of difficult intubation in our trail was 17.2%, 43 out of 250 patients. Of these only 27 were correctly predicted as difficult by Modified Mallampati test where as only 2 were predicted as difficult by Upper lip bite test and 39 were correctly predicted by neck circumference to Thyromental distance ratio. Among the three indices ratio of neck circumference to Thyromental distance has got highest sensitivity (90.7%) and specificity (94.6%). Conclusions: From our study we concluded that it is better to combine all three indices for accurate prediction of difficult intubation and among three ratio of neck circumference to Thyromental distance is the single best test.