Evaluation of ultrasound measurements of anterior neck soft tissue and other predictors of difficult laryngoscopy in morbidly obese patients

Evaluation of ultrasound measurements of anterior neck soft tissue and other predictors of difficult laryngoscopy in morbidly obese patients undergoing obesity surgery

Status

Completed

Phases

Unknown

Study type

Observational

Source

ANZCTR

Registry ID

ACTRN12617000532303

Enrollment

Registered

2017-04-11

Start date

2015-05-15

Completion date

2015-07-15

Last updated

2017-04-18

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

OBJECTIVE: The aim of our study was to compare the ultrasound (USG) measurements of anterior neck soft tissue and other clinical screening tests for difficult laryngoscopy in morbidly obese patients. METHODS: One hundred thirthy morbidly obese patients were scheduled for laparoscopic bariatric surgery in this retrospective trial. The USG examination was performed at vocal cords (zone 1), thyroid isthmus (zone 2), and suprasternal notch (zone3) levels. An anaesthesiologist who were unaware of the clinical screening variables and USG results performed laryngoscopy and trachea was intubated without styleted. When second attempt for intubation was failed, to use of other difficult intubation equipments were planned. RESULTS: Fifty six of 130 patients were excluded from study because of not meeting inclusion criteria. Laryngoscopic view was graded according to Cormack and Lehane's scale to decide difficult laryngoscopy. Seven patients were classified as having difficult laryngoscopy (9.5%). All of the patients were entubated succesfully within 3 attempts. CONCLUSION: We thought that USG measurement of anterior neck soft tissue has no influence on determination of difficult laryngoscopy in morbidly obese patients.

Interventions

observational study included (Older than 18 years old ASA (American Society of Anesthesiologists) I-II Body Mass Index (BMI) >35 kg/m2 Laparoscopic weight reduction surgery (sleeve gastrectomy) Under general anaesthesia with endotracheal intubation. Patients (Patients who had upper airway pathologies (maxillo-facial fracture, tumours, etc), pathology causing limitation in head-neck movement (cervical spine fractures, rhomatoid artiritis, ankylozan spondilitis, etc), contraindication of general anaesthesia (history of malign hiperthermia, full stomach, etc) or a history of difficult laryngoscopy or intubation were excluded from study. Mallampati test, mouth opening, sternomental distance, thyromental distance, upper lip bite test, neck circumference were recorded. The distance from the skin to the anterior aspect of the trachea was measured at three different levels: vocal cords (zone 1), thyroid isthmus (zone 2) and suprasternal notch (zone 3). An anaesthesiologist who were unaware of the clinical screening variables and ultrasonography results performed laryngoscopy. When second attempt for intubation was failed, to use of other difficult intubation equipments were planned. Each participant was followed up until the end of the operation

Eligibility

Sex/Gender

All

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

Older than 18 years old ASA (American Society of Anesthesiologists) I-II Body Mass Index (BMI) >35 kg/m2 Laparoscopic weight reduction surgery (sleeve gastrectomy) Under general anaesthesia with endotracheal intubation

Exclusion criteria

Patients who had upper airway pathologies (maxillo-facial fracture, tumours, etc), pathology causing limitation in head-neck movement (cervical spine fractures, rhomatoid artiritis, ankylozan spondilitis, etc), contraindication of general anaesthesia (history of malign hiperthermia, full stomach, etc) or a history of difficult laryngoscopy or intubation were excluded from study.

Outcome results