Department of Anaesthesiology and Critical Care, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India.
Department of OBG, JSS Medical College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India.
Ann Afr Med. 2023 Oct-Dec;22(4):520-525. doi: 10.4103/aam.aam_2_23.
STOP-BANG questionnaire is an established tool for obstructive sleep apnea (OSA) screening. Its utility in predicting difficult airway has not been evaluated. We intend to assess difficulty in airway management and associated perioperative complications in patients with undiagnosed OSA using the STOP-BANG questionnaire.
We performed a prospective observational study on 250 patients with the American Society of Anesthesiologists Physical Status Class I-II, aged 18-65 years STOP-BANG score were recorded. Occurrences of difficult mask ventilation (DMV), laryngoscopy, and intubation were assessed using mask ventilation grade, intubation difficulty score intubation difficult score (IDS), and modified Cormack-Lehane grading during induction of anesthesia. Hypoxic events, hemodynamic disturbances, laryngospasm, and bronchospasm were also recorded.
Overall, 250 patients completed the study (Group H: n = 102, with STOP-BANG questionnaire ≥3 and Group L: n = 148, with STOP-BANG criteria < 3). A total of 67 (26.8%) cases of DMV and 63 (25.2%) cases of difficult tracheal intubation (DIT) were encountered overall. The proportion of patients with DMV during induction was 59.8% in Group H versus 4.05% in Group L (P < 0.001). A higher incidence of difficult intubation was observed in Group H (56.9% vs. 11.5%, P < 0.001). More patients in Group H had airway complications such as bleeding and injury to the posterior pharyngeal wall or teeth (P < 0.001). Complications such as hypoxia, hypertension, and tachycardia were observed to be higher in Group H (P < 0.001).
STOP-BANG questionnaire is an effective bedside preoperative tool that helps in identifying unanticipated difficult airway.
STOP-BANG 问卷是阻塞性睡眠呼吸暂停（OSA）筛查的一种既定工具。但其预测困难气道的效用尚未得到评估。我们旨在使用 STOP-BANG 问卷评估未确诊 OSA 患者的气道管理困难和相关围手术期并发症。
我们对 250 名美国麻醉医师协会身体状况 I-II 级、年龄在 18-65 岁的患者进行了前瞻性观察研究，记录了 STOP-BANG 评分。在麻醉诱导期间，使用面罩通气分级、插管困难评分（IDS）和改良的 Cormack-Lehane 分级评估困难面罩通气（DMV）、喉镜检查和插管的发生情况。还记录了缺氧事件、血流动力学紊乱、喉痉挛和支气管痉挛。
总共有 250 名患者完成了研究（组 H：n = 102，STOP-BANG 问卷≥3；组 L：n = 148，STOP-BANG 标准<3）。总体上，有 67 例（26.8%）出现 DMV，63 例（25.2%）出现困难气管插管（DIT）。组 H 中诱导时出现 DMV 的患者比例为 59.8%，而组 L 中为 4.05%（P <0.001）。组 H 中观察到更频繁的困难插管（56.9% vs. 11.5%，P <0.001）。组 H 中更多的患者出现气道并发症，如出血、后咽壁或牙齿损伤（P <0.001）。组 H 中观察到缺氧、高血压和心动过速等并发症发生率较高（P <0.001）。
STOP-BANG 问卷是一种有效的术前床边工具，有助于识别意外的困难气道。
