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Original Research 


Analysis of various airway evaluation tests to prognosticate difficult endotracheal intubation

Nishana S, Gopakumar G, Prathibha V K, Ranju Jayaprakash, George K George.

Abstract
Background: Unanticipated difficult intubation or failure of intubation is a major source for anesthesia associated deaths. Hence pre-anesthetic checkup should include a detailed airway evaluation to foresee difficult endotracheal intubation. Some easy bedside tests to predict difficult airway include modified Mallampati test (MMT), ratio of height to thyromental distance (RHTMD), and upper lip bite test (ULBT). Actual difficulty of airway can be estimated using Cormack Lehane (CL) grading while performing laryngoscopy. Combination of two or more bedside clinical tests is used to identify difficult airway and act accordingly.

Aims and Objectives: We aimed at identifying those airway assessment tests which best predicted difficult airway. The objectives were to determine the agreement between MMT, RHTMD, ULBT with CL grading, and also the agreement between MMT and ULBT, MMT and RHTMD.

Materials and Methods: This observational research was done in 88 individuals between 18 and 75 years planned for elective procedures requiring endotracheal intubation as a part of general anesthesia. The clinical assessment tests such as ULBT, RHTMD, and MMT were done on eligible participants during pre-anesthetic check-up. In the operation theater, patient was prepared, premedicated, and induced. CL grading was used to assess the laryngoscopic view. We tried to determine the agreement between MMT, ULBT and RHTMD with CL grading. We also tried to determine the agreement between MMT and ULBT., MMT and RHTMD.

Results: MMT showed moderate, RHTMD showed slight, and ULBT showed no agreement with CL grading. MMT showed highest sensitivity and RHTMD showed highest specificity. No agreement was found for ULBT and RHTMD with MMT.

Conclusion: MMT and RHTMD can be used in predicting difficult airway access; out of which MMT is better than RHTMD. ULBT is not an ideal test to identify difficult endotracheal intubation. Laryngoscopic view becomes difficult with increase in weight and age.

Key words: Modified Mallampati Test; Ratio of Height to Thyromental Distance; Upperlip Bite Test; Cormack and Lehane Grading; Difficult Airway


 
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How to Cite this Article
Pubmed Style

S N, G G, K PV, Jayaprakash R, George GK. Analysis of various airway evaluation tests to prognosticate difficult endotracheal intubation. Natl J Physiol Pharm Pharmacol. 2024; 14(2): 198-205. doi:10.5455/njppp.2023.13.06315202326062023


Web Style

S N, G G, K PV, Jayaprakash R, George GK. Analysis of various airway evaluation tests to prognosticate difficult endotracheal intubation. https://www.njppp.com/?mno=157031 [Access: January 31, 2024]. doi:10.5455/njppp.2023.13.06315202326062023


AMA (American Medical Association) Style

S N, G G, K PV, Jayaprakash R, George GK. Analysis of various airway evaluation tests to prognosticate difficult endotracheal intubation. Natl J Physiol Pharm Pharmacol. 2024; 14(2): 198-205. doi:10.5455/njppp.2023.13.06315202326062023



Vancouver/ICMJE Style

S N, G G, K PV, Jayaprakash R, George GK. Analysis of various airway evaluation tests to prognosticate difficult endotracheal intubation. Natl J Physiol Pharm Pharmacol. (2024), [cited January 31, 2024]; 14(2): 198-205. doi:10.5455/njppp.2023.13.06315202326062023



Harvard Style

S, N., G, . G., K, . P. V., Jayaprakash, . R. & George, . G. K. (2024) Analysis of various airway evaluation tests to prognosticate difficult endotracheal intubation. Natl J Physiol Pharm Pharmacol, 14 (2), 198-205. doi:10.5455/njppp.2023.13.06315202326062023



Turabian Style

S, Nishana, Gopakumar G, Prathibha V K, Ranju Jayaprakash, and George K George. 2024. Analysis of various airway evaluation tests to prognosticate difficult endotracheal intubation. National Journal of Physiology, Pharmacy and Pharmacology, 14 (2), 198-205. doi:10.5455/njppp.2023.13.06315202326062023



Chicago Style

S, Nishana, Gopakumar G, Prathibha V K, Ranju Jayaprakash, and George K George. "Analysis of various airway evaluation tests to prognosticate difficult endotracheal intubation." National Journal of Physiology, Pharmacy and Pharmacology 14 (2024), 198-205. doi:10.5455/njppp.2023.13.06315202326062023



MLA (The Modern Language Association) Style

S, Nishana, Gopakumar G, Prathibha V K, Ranju Jayaprakash, and George K George. "Analysis of various airway evaluation tests to prognosticate difficult endotracheal intubation." National Journal of Physiology, Pharmacy and Pharmacology 14.2 (2024), 198-205. Print. doi:10.5455/njppp.2023.13.06315202326062023



APA (American Psychological Association) Style

S, N., G, . G., K, . P. V., Jayaprakash, . R. & George, . G. K. (2024) Analysis of various airway evaluation tests to prognosticate difficult endotracheal intubation. National Journal of Physiology, Pharmacy and Pharmacology, 14 (2), 198-205. doi:10.5455/njppp.2023.13.06315202326062023