Rana Vandana, Mehrotra Shreesh, Asthana Veena, Raghuvanshi Shailendra
Department of Anaesthesia, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India.
Department of Radiodiagnosis, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India.
Anesth Essays Res. 2022 Jan-Mar;16(1):109-114. doi: 10.4103/aer.aer_28_22. Epub 2022 Jun 29.
The incidence of difficult tracheal intubation includes not only difficult and failed intubation but also difficult laryngoscopy (DL) and difficult mask ventilation.
The study was done to compare the sonographic assessment of tongue thickness (TT) and condylar mobility with traditional airway assessment scores for prediction of difficult intubation (DI).
This experimental, randomized prospective study was conducted in the Department of Anaesthesia, Himalayan Institute of Medical Sciences, Dehradun.
After obtaining approval from the Institutional Ethical and Research Committee, this study was conducted in the Department of Anaesthesiology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Swami Ram Nagar, Dehradun. After obtaining written and informed consent, 385 subjects of either sex between 18 and 60 years of age, undergoing various elective surgeries under general anesthesia with endotracheal intubation, were selected. The number of attempts at intubation, the need for alternative DI approaches, and invasive airway access or cancellation of the procedure due to inability to secure the airway were noted.
Data analysis was done using SPSS 20.0. Categorical data were assessed by Chi-square test, while independent -test/Mann-Whitney test was used to determine the association between continuous data.
Age, inter-incisor distance (IID), body mass index (BMI), and Mallampati score were positively correlated with TT. BMI (kg.m) >26.0, modified Mallampati scoring >2, IID ≤5 cm, TT >6 cm, and condylar mobility >10 mm were significantly more among subjects with DL and difficult tracheal intubation.
Ultrasonography can be used in elective settings to rule out any possibility of difficult airway and to prevent airway-related complications.
困难气管插管的发生率不仅包括插管困难和失败，还包括困难喉镜检查（DL）和困难面罩通气。
本研究旨在比较超声评估舌厚度（TT）和髁突活动度与传统气道评估评分对困难插管（DI）的预测价值。
本实验性随机前瞻性研究在德拉敦喜马拉雅医学科学研究所麻醉科进行。
获得机构伦理与研究委员会批准后，本研究在德拉敦斯瓦米拉玛喜马拉雅大学喜马拉雅医学科学研究所麻醉科进行。获得书面知情同意后，选取385例年龄在18至60岁之间、接受全身麻醉气管插管下各种择期手术的男女受试者。记录插管尝试次数、是否需要采用替代的困难插管方法、因无法确保气道安全而进行有创气道通路建立或取消手术的情况。
使用SPSS 20.0进行数据分析。分类数据采用卡方检验评估，连续数据之间的关联采用独立样本t检验/曼-惠特尼检验确定。
年龄、上门齿间距离（IID）、体重指数（BMI）和马兰帕蒂评分与TT呈正相关。BMI（kg·m）>26.0、改良马兰帕蒂评分>2、IID≤5 cm、TT>6 cm以及髁突活动度>10 mm在DL和困难气管插管受试者中显著更多见。
超声检查可用于择期手术中排除困难气道的可能性，预防气道相关并发症。
