Jain Mamta, Lal Jatin, Aggrawal Diya, Sharma Jyoti, Singh Anish K, Bansal Teena
Anesthesia, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, IND.
Anesthesia, All India Institute of Medical Sciences, Bathinda, IND.
Cureus. 2022 Jun 8;14(6):e25767. doi: 10.7759/cureus.25767. eCollection 2022 Jun.
Perioperative airway changes due to anesthesia and surgery could change a normal airway at induction to a risky airway at extubation.
The objective is to evaluate primarily the degree of airway changes, as quantified by the modified Mallampati (MMP) class, after spine surgery in the prone position. Secondary to assess the time required for these changes to revert back to the preoperative state and their correlation with other demographic and surgical variables.
The present prospective observational study was conducted in a tertiary care hospital after ethical approval and trial registration. Fifty ASA I and II patients aged 18-65 years of both sex and undergoing spine surgery in prone positions were included. Supine MMP grade was observed preoperatively and at one, two, four, 24, and 48 hours postoperatively.
IBM SPSS version 22 (IBM Corp, Armonk, NY) was used.Mean values were compared using paired t-tests and medians by the Wilcoxon test. The Spearman correlation was used to assess a relationship. The time for recovery was analyzed by Kaplan-Meir analysis.
An increase in MMP grade was observed at one hour postoperatively in 46 (92%) patients. Changes reverted back in 45 (98%) patients by 24 hours postoperatively. A weak positive correlation with age, weight, body mass index, duration of surgery, perioperative drop in hemoglobin, and a moderate positive correlation with fluid administered and estimated blood loss was recorded.
An increase in postoperative MMP occurs in the majority of patients undergoing prone position spine surgery which may persist up to 48 hours. So, more vigilance and caution are warranted should reintubation be needed postoperatively.
麻醉和手术引起的围手术期气道变化可能使诱导时的正常气道在拔管时变为危险气道。
主要评估俯卧位脊柱手术后气道变化的程度，以改良马兰帕蒂（MMP）分级进行量化。其次评估这些变化恢复到术前状态所需的时间及其与其他人口统计学和手术变量的相关性。
本前瞻性观察性研究在一家三级护理医院进行，经伦理批准并进行了试验注册。纳入50例年龄在18 - 65岁、ASA I级和II级、性别不限且接受俯卧位脊柱手术的患者。术前及术后1小时、2小时、4小时、24小时和48小时观察仰卧位MMP分级。
使用IBM SPSS 22版（IBM公司，纽约州阿蒙克）。均值比较采用配对t检验，中位数比较采用威尔科克森检验。采用斯皮尔曼相关性分析评估关系。恢复时间采用Kaplan - Meir分析。
术后1小时，46例（92%）患者MMP分级升高。术后24小时，45例（98%）患者的变化恢复。记录到与年龄、体重、体重指数、手术时间、围手术期血红蛋白下降呈弱正相关，与补液量和估计失血量呈中度正相关。
大多数接受俯卧位脊柱手术的患者术后MMP升高，可能持续长达48小时。因此，如果术后需要重新插管，应更加警惕和谨慎。
