Balık Onurcan, Özden Eyyüp Sabri, Özcan Mustafa Soner, Solmaz Filiz Alkaya, Kırdemir Pakize
Department of Anesthesiology and Reanimation, Faculty of Medicine, Suleyman Demirel University, Operating Room, Floor:1, Cunur, Isparta, 32260, Turkey.
BMC Anesthesiol. 2025 Jan 29;25(1):46. doi: 10.1186/s12871-025-02926-1.
This study aimed to compare the effectiveness of the NoSAS, STOP-Bang, and Berlin scoring systems, which are utilized to predict obstructive sleep apnea syndrome (OSAS), in forecasting difficult airway management. Additionally, the study sought to determine which of these scoring systems is the most practical and effective for this purpose.
Following the ethics committee approval, preoperative NoSAS, STOP-Bang, and Berlin scores were calculated for 420 patients aged 18 years and older who were scheduled for tracheal intubation. Mask ventilation and intubation were performed by research assistant with a minimum of two years of experience. Detailed examinations and recordings were conducted, including demographic data, neck circumference, OSAS diagnosis, history of difficult intubation, comorbidities, ASA classification, Mallampati classification, and Cormack-Lehane grade. Subsequently, the predictive efficacy of these three scoring systems for difficult mask ventilation and difficult intubation was compared.
In our study, 83 patients (19.8%) were classified as having difficult mask ventilation, and 101 patients (24.0%) were classified as having difficult intubation. The NoSAS score demonstrated a higher predictive power compared to the other scoring systems for difficult mask ventilation and difficult intubation. The cut-off value for the NoSAS score was determined to be 6.5 for predicting difficult mask ventilation and 7.5 for predicting difficult intubation.
The routine implementation of the NoSAS score, an easy-to-use, rapid and objective tool primarily developed for OSAS screening, is likely to be effective in preoperatively identifying difficult airways in patients undergoing general anesthesia.
本研究旨在比较用于预测阻塞性睡眠呼吸暂停综合征（OSAS）的NoSAS、STOP-Bang和柏林评分系统在预测困难气道管理方面的有效性。此外，该研究还试图确定这些评分系统中哪一个在此目的上最实用和有效。
在伦理委员会批准后，为420例计划行气管插管的18岁及以上患者计算术前NoSAS、STOP-Bang和柏林评分。由至少有两年经验的研究助理进行面罩通气和插管操作。进行了详细的检查和记录，包括人口统计学数据、颈围、OSAS诊断、困难插管史、合并症、ASA分级、Mallampati分级和Cormack-Lehane分级。随后，比较这三种评分系统对困难面罩通气和困难插管的预测效能。
在我们的研究中，83例患者（19.8%）被归类为面罩通气困难，101例患者（24.0%）被归类为插管困难。与其他评分系统相比，NoSAS评分在预测困难面罩通气和困难插管方面显示出更高的预测能力。预测困难面罩通气时NoSAS评分的截断值确定为6.5，预测困难插管时为7.5。
NoSAS评分是一种主要为OSAS筛查而开发的易于使用、快速且客观的工具，常规应用可能有助于在术前识别接受全身麻醉患者的困难气道。
