Department of Anesthesiology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan; College of Medicine, Tzu Chi University, Hualien, Taiwan.
Department of Research, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
Ultrasound Med Biol. 2021 Aug;47(8):2243-2249. doi: 10.1016/j.ultrasmedbio.2021.04.004. Epub 2021 May 19.
The goal of this study was to determine the utility of submental ultrasound parameters in distinguishing difficult airway management from easy airway management. Forty-one adult patients who underwent elective surgery under general anesthesia with endotracheal intubation from March to December 2018 were included. We used submental ultrasound to measure tongue base thickness (TBT) in the midsagittal plane and the distance between lingual arteries (DLA) in the transverse dimension. The primary outcome was difficult laryngoscopy, and the secondary outcome was difficult mask ventilation. Receiver operating characteristic curve analysis and logistic regression revealed no correlation between difficult laryngoscopy and SMUS measurements. Nevertheless, patients with difficult mask ventilation had significantly higher TBT (p = 0.009) and longer DLA (p = 0.010). After adjustment of confounding factors, increased TBT (>69.6 mm) was the sole independent predictor of difficult mask ventilation. The results indicated that SMUS is effective in predicting difficult mask ventilation but not difficult laryngoscopy.
本研究旨在确定颏下超声参数在区分困难气道管理与容易气道管理中的作用。纳入 2018 年 3 月至 12 月期间在全身麻醉下行气管内插管择期手术的 41 例成年患者。我们使用颏下超声测量正中矢状面舌骨下肌厚度（TBT）和舌动脉横径（DLA）。主要结局为喉镜检查困难，次要结局为面罩通气困难。受试者工作特征曲线分析和逻辑回归显示，喉镜检查困难与 SMUS 测量值之间无相关性。然而，面罩通气困难的患者 TBT 显著升高（p=0.009），DLA 更长（p=0.010）。调整混杂因素后，TBT 增加（＞69.6mm）是面罩通气困难的唯一独立预测因子。结果表明，SMUS 可有效预测面罩通气困难，但不能预测喉镜检查困难。
