Kandemir Tünay, Şavlı Serpil, Ünver Süheyla, Kandemir Erbin
Clinic of Anaesthesia, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey.
Turk J Anaesthesiol Reanim. 2015 Feb;43(1):7-12. doi: 10.5152/TJAR.2014.24993. Epub 2014 Sep 9.
The aim of this study was to determine the combinations of the Mallampati test and anthropometric measurements with the highest selectivity value. In addition, we aim to identify a possible correlation between head circumference measurement, the presence of malignancy and difficult intubation.
Patients who were scheduled to undergo elective surgery under general anaesthesia, who fell into Group 1-2 according to ASA criteria and were between the ages of 18-70 years were included in the study. Patients with Cormack-Lehane scores of 3-4 were considered to be difficult intubations. Thyromental distance, sternomental distance, mandibular distance, neck length, neck circumference and head circumference were measured during the anthropometric measurements.
According to the ROC analysis, there was a significant difference in the thyromental distance, sternomental distance, neck length, neck circumference and head circumference between the easy and difficult intubation groups (p<0.05). The incidence of difficult intubation was 8.3% in patients with non-head-neck malignancies, whereas the incidence was 7.1% in patients without any malignancies. The difference between these groups was not statistically significant (χ(2)=0.101; p=0.751).
To predict the incidence of difficult intubation, the test with the highest selectivity and highest positive predictive values was the combination of Mallampati-thyromental distance. We believe that the head circumference and neck length measurement, in addition to the current anthropometric measurements, may be crucial to predict the incidence of difficult intubations. In addition, we believe that the anticipation of difficult intubations in patients with non-head-neck malignancies is not different from the normal population.
本研究旨在确定具有最高选择性值的马兰帕蒂试验和人体测量学指标的组合。此外,我们旨在确定头围测量、恶性肿瘤的存在与困难插管之间的可能相关性。
纳入计划在全身麻醉下接受择期手术、根据美国麻醉医师协会(ASA)标准属于1-2级且年龄在18-70岁之间的患者。科马克-莱汉内评分为3-4分的患者被视为困难插管。在人体测量期间测量颏甲距离、胸骨颏距离、下颌距离、颈部长度、颈围和头围。
根据ROC分析,容易插管组和困难插管组在颏甲距离、胸骨颏距离、颈部长度、颈围和头围方面存在显著差异(p<0.05)。非头颈部恶性肿瘤患者的困难插管发生率为8.3%,而无任何恶性肿瘤的患者发生率为7.1%。这些组之间的差异无统计学意义(χ(2)=0.101;p=0.751)。
为预测困难插管的发生率,选择性和阳性预测值最高的试验是马兰帕蒂-颏甲距离的组合。我们认为,除了目前的人体测量指标外,头围和颈部长度测量对于预测困难插管的发生率可能至关重要。此外,我们认为非头颈部恶性肿瘤患者困难插管的预期与正常人群无异。