Risk Factors Assessment of the Difficult Intubation using Intubation Difficulty Scale (IDS)
Background: The major responsibility of anaesthesiologist is to maintain adequate gas exchange in his patients in all circumstances and this require that patency of upper airway is constantly maintained. Problems with upper airway management are among the most frequent causes of anaesthetic mish...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2014-07-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/4560/8506_CE[Ra1]_F(DK)_PF1(PAK)_PFA(AK)_PF2(AGAK)_PF2(PN).pdf |
| _version_ | 1819203039440928768 |
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| author | Vaibhav K.Nasa Shaila S.Kamath |
| author_facet | Vaibhav K.Nasa Shaila S.Kamath |
| author_sort | Vaibhav K.Nasa |
| collection | DOAJ |
| description | Background: The major responsibility of anaesthesiologist
is to maintain adequate gas exchange in his patients in all
circumstances and this require that patency of upper airway is
constantly maintained. Problems with upper airway management
are among the most frequent causes of anaesthetic mishaps.
Using intubation difficulty scale (IDS) we made an attempt to
objectively assess the predictors of difficult intubation. We
assessed classical bedside tests such as modified Mallampati
test, Thyromental distance test and also neck extension test.
Methods: We prospectively observed 400 patients undergoing
general anaesthesia with endotracheal intubation, for each
patient intubation difficulty score was recorded during intubation.
Risk factors assessment of difficult intubation done using IDS.
Risk factor assessed includes modified mallampati class III
and IV, thyromental distance ≤ 6cm and neck extension < 5cm.
Patients were categorised as Easy intubation (IDS, 0 to 2), slightly
difficult intubation (IDS, 3 to 4) and difficult intubation (IDS 5).
Preoperative airway assessment was done by thyromental
distance measurement, neck extension measurement and
modified mallampati test. Data was analysed using Receiver
operating characteristic (ROC) curve and area under curve (AUC)
for each test computed. p<0.05 was considered significant.
Results: The incidence of difficult intubation was 8% and there
were no failure to intubate the trachea. The AUC were as follows:
modified Mallampati test 0.473 (p<0.005), Thyromental distance
test 0.753 (p<0.005) and neck extension test 0.768 (p<0.005).
Conclusion: The results indicate that neck extension test is
strongest predictor of difficult intubation (IDS≥5) in comparison
to Thyromental test and modified mallampati test. |
| first_indexed | 2024-12-23T04:13:35Z |
| format | Article |
| id | doaj.art-97eccc5582644c289d8522517e282edd |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-23T04:13:35Z |
| publishDate | 2014-07-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-97eccc5582644c289d8522517e282edd2022-12-21T18:00:25ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2014-07-0187GC01GC0310.7860/JCDR/2014/8506.4560Risk Factors Assessment of the Difficult Intubation using Intubation Difficulty Scale (IDS)Vaibhav K.Nasa0Shaila S.Kamath1Postgraduate, Department of Anaesthesiology, Kasturba Medical College, Mangalore, Manipal University, Manipal, India.Associate Professor, Department of Anaesthesiology, Kasturba Medical College, Mangalore, Manipal University, Manipal, India.Background: The major responsibility of anaesthesiologist is to maintain adequate gas exchange in his patients in all circumstances and this require that patency of upper airway is constantly maintained. Problems with upper airway management are among the most frequent causes of anaesthetic mishaps. Using intubation difficulty scale (IDS) we made an attempt to objectively assess the predictors of difficult intubation. We assessed classical bedside tests such as modified Mallampati test, Thyromental distance test and also neck extension test. Methods: We prospectively observed 400 patients undergoing general anaesthesia with endotracheal intubation, for each patient intubation difficulty score was recorded during intubation. Risk factors assessment of difficult intubation done using IDS. Risk factor assessed includes modified mallampati class III and IV, thyromental distance ≤ 6cm and neck extension < 5cm. Patients were categorised as Easy intubation (IDS, 0 to 2), slightly difficult intubation (IDS, 3 to 4) and difficult intubation (IDS 5). Preoperative airway assessment was done by thyromental distance measurement, neck extension measurement and modified mallampati test. Data was analysed using Receiver operating characteristic (ROC) curve and area under curve (AUC) for each test computed. p<0.05 was considered significant. Results: The incidence of difficult intubation was 8% and there were no failure to intubate the trachea. The AUC were as follows: modified Mallampati test 0.473 (p<0.005), Thyromental distance test 0.753 (p<0.005) and neck extension test 0.768 (p<0.005). Conclusion: The results indicate that neck extension test is strongest predictor of difficult intubation (IDS≥5) in comparison to Thyromental test and modified mallampati test.https://jcdr.net/articles/PDF/4560/8506_CE[Ra1]_F(DK)_PF1(PAK)_PFA(AK)_PF2(AGAK)_PF2(PN).pdfairwaydifficult intubationmallampati |
| spellingShingle | Vaibhav K.Nasa Shaila S.Kamath Risk Factors Assessment of the Difficult Intubation using Intubation Difficulty Scale (IDS) Journal of Clinical and Diagnostic Research airway difficult intubation mallampati |
| title | Risk Factors Assessment of the Difficult Intubation using Intubation Difficulty Scale (IDS) |
| title_full | Risk Factors Assessment of the Difficult Intubation using Intubation Difficulty Scale (IDS) |
| title_fullStr | Risk Factors Assessment of the Difficult Intubation using Intubation Difficulty Scale (IDS) |
| title_full_unstemmed | Risk Factors Assessment of the Difficult Intubation using Intubation Difficulty Scale (IDS) |
| title_short | Risk Factors Assessment of the Difficult Intubation using Intubation Difficulty Scale (IDS) |
| title_sort | risk factors assessment of the difficult intubation using intubation difficulty scale ids |
| topic | airway difficult intubation mallampati |
| url | https://jcdr.net/articles/PDF/4560/8506_CE[Ra1]_F(DK)_PF1(PAK)_PFA(AK)_PF2(AGAK)_PF2(PN).pdf |
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