Kurtipek Omer, Isik Berrin, Arslan Mustafa, Unal Yusuf, Kizil Yusuf, Kemaloglu Yusuf
Department of Anesthesiology and Reanimation, Faculty of Medicine, Gazi University, Besevler, Ankara, Turkey.
J Res Med Sci. 2012 Jul;17(7):615-20.
Obstructive sleep apnea (OSA) syndrome is predisposed to the development of upper airway obstruction during sleep, and it poses considerable problem for anesthetic management. Difficult intubation (DI) is an important problem for management of anesthesia. In this clinical research, we aim to investigate the relationship between DI and prediction criteria of DI in cases with OSA.
We studied 40 [OSA (Group O, n = 20) and non-OSA, (Group C, n = 20)] ASA I-II, adult patients scheduled tonsillectomy under general anesthesia. Same anesthetic protocol was used in two groups. Intubation difficulties were assessed by Mallampati grading, Wilson sum score, Laryngoscopic grading (Cormack and Lehane), a line joining the angle of the mouth and tragus of the ear with the horizontal, sternomental distance, and tyromental distance. Demographic properties, time-dependent hemodynamic variables, doses of reversal agent, anesthesia and operation times, and recovery parameters were recorded.
Significant difference was detected between groups in terms of BMI, Mallampati grading, Wilson weight scores, Laryngoscopic grading, sternomental distance, tyromental distance, doses of reversal agent, and recovery parameters.
OSA patient's DI ratio is higher than that of non-OSA patients. BMI Mallampati grading, Wilson weight scores, Laryngoscopic grading, sternomental distance, and tyromental distance evaluation might be predictors for DI in patients with OSA.
阻塞性睡眠呼吸暂停(OSA)综合征易导致睡眠期间上呼吸道阻塞,给麻醉管理带来诸多问题。困难插管(DI)是麻醉管理中的一个重要问题。在本临床研究中,我们旨在探讨OSA患者中DI与DI预测标准之间的关系。
我们研究了40例[OSA组(O组,n = 20)和非OSA组(C组,n = 20)]美国麻醉医师协会(ASA)分级为I-II级、计划在全身麻醉下进行扁桃体切除术的成年患者。两组采用相同的麻醉方案。通过Mallampati分级、Wilson总分、喉镜分级(Cormack和Lehane)、连接口角与耳屏的线与水平线的夹角、胸骨颏距离和颏下颌距离评估插管困难程度。记录人口统计学特征、时间依赖性血流动力学变量、逆转剂剂量、麻醉和手术时间以及恢复参数。
两组在体重指数(BMI)、Mallampati分级、Wilson体重评分、喉镜分级、胸骨颏距离、颏下颌距离、逆转剂剂量和恢复参数方面存在显著差异。
OSA患者的DI发生率高于非OSA患者。BMI、Mallampati分级、Wilson体重评分、喉镜分级、胸骨颏距离和颏下颌距离评估可能是OSA患者DI的预测指标。