Aim: To determine the incidence of a difficult airway and which parameter will be suitable to predict it in the Sikkimese population.
Material and methods: This observational single-blinded study was done on 500 patients between 18 to 65 years of age coming for surgery under general anaesthesia. The airway parameters assessed were the Modified Mallampati test (MMP), Inter incisor gap (IG), Thyromental distance (TMD), Sternomental distance (SMD) and Mandibular protrusion (MP), along with demographic characteristics. Then difficult intubation was graded according to the Cormack-Lehane classification and was compared with the parameters mentioned above.
Result: 86 patients had difficult intubation, with an incidence of 17.20%. Gender and different ethnicity showed significant association. MMP, TMD and among combination test MMP+TMD, MMP+SMD was statistically significant. The maximum AUC of the ROC curve was seen in TMD (0.65), followed by MMP+TMD (0.615). The Mandibular protrusion has the highest sensitivity (100%). The MMP showed the least sensitivity (27.91%) but the highest specificity (93%), PPV (45.3%) and diagnostic accuracy (81.8%). The sensitivity for MMP was found to be increased in combined parameters MMP + SMD (73.26%) and MMP + TMD (55.81%).
Conclusion: It's better to use a combination of tests to predict difficult airways. TMD, MMP+TMD and MMP+SMD can be used.
Key words: Difficult airway, Cormack Lehane Grade, Inter incisor Gap, Modified Mallampati Test, Sternomental Distance, Thyromental Distance
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