Moslemi Farnaz, Khan Zahid Hussain, Alizadeh Elham, Khamnian Zhila, Eftekhar Negar, Hosseini Mohammad-Salar, Mahmoodpoor Ata
Department of Anesthesiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Anesthesiology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
J Perioper Pract. 2023 Apr;33(4):116-121. doi: 10.1177/17504589211045231. Epub 2021 Nov 18.
Difficult airway and intubation can have dangerous sequela for patients if not managed promptly. This issue is even more challenging among obstetric patients. Several studies have aimed to determine whether the test to predict a difficult airway or difficult intubation, is higher in accuracy. This study aims to compare the upper lip bite test with the modified Mallampati test in predicting difficult airway among obstetric patients. During this prospective observational study, 184 adult pregnant women, with ASA physical status of II, were enrolled. Difficult intubations of Cormack-Lehane grade III and IV were defined as difficult airways and difficult intubation in this study. Upper lip bite test, modified Mallampati test, thyromental distance and sternomental distance were noted for all patients. Modified Mallampati test, upper lip bite test and sternomental distance had highest specificity. Based on regression analysis, body mass index and Cormack-Lehane grade have a significant association. Modified Mallampati test was the most accurate test for predicting difficult airway. The best cut-off points of thyromental distance and sternomental distance in our study were 5cm and 15cm, respectively, by receiver operating characteristic curve analysis. Based on the results of the present study, it can be concluded that in the obstetric population, modified Mallampati test is practically the best test for predicting difficult airway. However, combining this test with upper lip bite test, thyromental distance and sternomental distance might result in better diagnostic accuracy.
如果处理不及时，困难气道和插管对患者可能会产生危险后果。这个问题在产科患者中更具挑战性。多项研究旨在确定预测困难气道或困难插管的测试准确性是否更高。本研究旨在比较上唇咬试验与改良马兰帕蒂试验在预测产科患者困难气道方面的效果。在这项前瞻性观察研究中，纳入了184例ASA身体状况为II级的成年孕妇。本研究将科马克-莱汉内分级III级和IV级的困难插管定义为困难气道和困难插管。记录了所有患者的上唇咬试验、改良马兰帕蒂试验、甲状软骨-颏下距离和胸骨上窝-颏下距离。改良马兰帕蒂试验、上唇咬试验和胸骨上窝-颏下距离具有最高的特异性。基于回归分析，体重指数与科马克-莱汉内分级有显著关联。改良马兰帕蒂试验是预测困难气道最准确的测试。通过受试者工作特征曲线分析，本研究中甲状软骨-颏下距离和胸骨上窝-颏下距离的最佳截断点分别为5cm和15cm。根据本研究结果，可以得出结论，在产科人群中，改良马兰帕蒂试验实际上是预测困难气道的最佳测试。然而，将该测试与上唇咬试验、甲状软骨-颏下距离和胸骨上窝-颏下距离相结合可能会提高诊断准确性。
