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Volume 12 Issue 2 ( April- June) 2023

Original Articles

The preoperative evaluation of risk variables associated with difficult intubation
Dr. Neha Sharma, Dr. Suman Shekhar Tiwari, Dr. Anurag Srivastava, Dr. Prakriti Gupta

Aim: The preoperative evaluation of risk variables associated with difficult intubation is the goal. Material and methods: Consent to participate in the study was obtained from one hundred adults of either gender who were planned to undergo elective procedures requiring general anaesthesia and tracheal intubation, including abdominal, urological, neurosurgical, ophthalmic, cardiac, orthopaedic, and ENT operations. After inducing the patients with injections of thiopentone sodium 5 mg/Kg, nalbuphine 0.1 mg/Kg, and atracurium 0.5 mg/Kg, a laryngoscopy was carried out after three minutes. Throughout the process of intubation, some details were recorded, such as the number of tries, the best view of laryngoscopy, the required size of the blade, and whether or not tracheal pressure was administered. The view at larngoscopy was graded by Cormack Lehane in the following manner:Grade 1 - if part of vocal cord visible. Grade 2 - if only the arytenoids were visible. Grade 3 - if only epiglottis was visible. Grade 4 - if epiglottis was not visible. Results: The incidence of difficult intubation, as determined by nine different characteristics, is three percent (3%) out of every hundred instances. One of these was a Cormack-Lehane Grade II case, one was a Grade III case, and one was a Grade IV case. Of the Grade III cases, one was intubated on the third attempt with the stylet, and the other was intubated by manipulation. The Grade IV case was intubated with the assistance of an intubating laryngeal mask. Mallampati class-3, neck circumference >40cms, and subluxation grade-2 each had a sensitivity of 35%, 19%, and 18% respectively; only one patient with inter-incisor distance of 3cms had a 100% sensitivity. Conclusion: This study found that an inter-incisor distance of 3 centimetres was the most sensitive predictor for difficult intubation, followed by a Mallampati class-3, a neck circumference of more than 40 centimeters, and a subluxation grade-2. Even though all of the tests have their uses, the study came to the conclusion that an inter-incisor distance of 3 centimeters was the most sensitive predictor.

 
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