Difficult Airway Intubation
Conditions
Brief summary
Since the introduction of real-time ultrasound (US) capabilities, ultrasound technology has been adopted and incorporated into daily practice by many medical and surgical specialties. Using US to help assess the difficult airway constitutes just yet another valuable application of this versatile technology . Since many anesthesia providers had already acquired proficiency in US techniques in US guided vascular access and regional nerve blocks, using US to evaluate the airway could be learned and mastered without too much difficulty. Ultrasound of the upper airway may prove to become a useful adjunct to conventional clinical assessment tools, as it has been successful in visualizing the relevant anatomy and critical structures of the airway..
Detailed description
The study is cross sectional observational study in which obese patients will be assessed using conventional clinical methods of airway assessment and by using US for the same patient before induction of anesthesia then correlated to the Cormack-Lehane finding after induction of anesthesia..
Interventions
DEVICEAssessing validity of ultrasound as regards correlation to Cormack-Lehane grading in obese patients
Assessing validity of ultrasound as regards correlation to Cormack-Lehane grading in obese patients
Sponsors
Zagazig University
Study design
Observational model
OTHER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
21 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* Age of the patient : (21-60) years old. * Sex : male & female. * Physical Status : The American Society of Anesthesiologists (ASA) II-III patients. * Body mass index : 30 to more than 30 kg / m² . * Operations: Laparoscopic surgeries,bariatric surgeries and any operation that requires general anesthesia with endotracheal tube placement .
Exclusion criteria
Patient refusal. * Deformity of the airway anatomy \[by masses or tumors\]. * Patients with thyroid swellings 'Goitre'. * Pathology of the airway \[edema,burn and arthritis\].
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The ratio of the depth of the pre-epiglottic space (Pre-E) to the distance from the epiglottis to the mid-point of the distance between the vocal cords (E-VC). | through study completion, an average of 1 year | If It is \[0-1\] ,this suspects Cormack-Lehane Grade 1.If it is \[1-2\],this suspects Cormack-Lehane Grade 2.If it is \[2-3\],this suspects Cormack-Lehane Grade 3 |
| The anterior neck soft tissue thickness at the level of the vocal cords (ANS-VC) | through study completion, an average of 1 year | ANS-VC \>0.23 cm had a sensitivity of 85.7% in predicting a Cormack-Lehan Grade 3 or 4 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Tongue volume will be derived from multiplication of the midsagittal cross-sectional area of the tongue by its width obtained from transverse sonograms | through study completion, an average of 1 year | Large tongue volume suspects difficult laryngoscopy |
| Modified Mallampati classification | through study completion, an average of 1 year | Class I is visualization of the hard palate, soft palate, fauces, uvula, and pillars. Class II is visualization of the hard palate, soft palate, fauces, and base of uvula. Class III is visualization of the hard palate and soft palate. Class IV is visualization of only the hard palate |
| Interincisor gap | through study completion, an average of 1 year | If it is less than 5 cm (approximately three finger breadths) with limited forward protrusion of the mandible ,this is associated with increased risk of difficult laryngoscopy |
| The anterior neck soft tissue thickness at the level of the hyoid bone (ANS-Hyoid) | through study completion, an average of 1 year | If it is 1.69 cm \[1.19 cm to 2.19 cm\],this suspects difficult laryngoscopy.If it is 1.37cm \[1.27 cm to 1.46 cm\], this suspects easy laryngoscopy |
| Sternomental distance | through study completion, an average of 1 year | If \< 12.5 cm ,this predicts difficult laryngoscopy |
| Neck Extension and Flexion | through study completion, an average of 1 year | inability to extend or flex the neck suspects difficult laryngoscopy |
| Thyromental distance | through study completion, an average of 1 year | If \< 6cm ,this predicts difficult laryngoscopy |
| The hyomental distance of the patient in neutral position of the neck and in fully extended neck calculating the ratio between both of them | through study completion, an average of 1 year | If The mean hyomental distance ratios is (1.02 ± 0.01) ,this suspects difficult intubation.If it is (1.14 ± 0.02) ,this suspects easy intubation |
Countries
Egypt
Contacts
Primary ContactEl-Tawansy
Outcome results
None listed