Difficult Airway, Difficult Intubation, Difficult Mask Ventilation
Conditions
Keywords
Airway Ultrasonography, Ultrasound, Difficult Airway Prediction, Anesthesia
Brief summary
Difficult airway management is a major cause of perioperative complications. Standard bedside airway assessment tests may have limited ability to predict difficult intubation and difficult mask ventilation. This prospective observational study aims to evaluate whether preoperative ultrasound measurements of airway structures (such as skin-to-epiglottis distance, tongue thickness, and pre-epiglottic space) can predict difficult intubation and difficult mask ventilation in adult patients undergoing surgery under general anesthesia.
Detailed description
This prospective observational cohort study was conducted to evaluate the predictive value of preoperative ultrasonographic airway measurements for difficult intubation and difficult mask ventilation in adult patients undergoing elective surgery under general anesthesia. A total of 400 patients aged 18-70 years with ASA physical status I-III were included. Before induction of anesthesia, standard clinical airway assessment tests were recorded, and ultrasound measurements were performed to assess airway-related anatomical structures. Ultrasonographic parameters included skin-to-epiglottis distance, skin-to-thyroid cartilage distance, thyroid cartilage-to-epiglottis distance, pre-epiglottic space depth, tongue thickness, and hyomental distance measurements. Intraoperatively, mask ventilation and intubation conditions were documented. Difficult intubation was defined as requiring two or more intubation attempts. Difficult mask ventilation was defined as the need for two-handed mask ventilation or inability to ventilate adequately using a face mask. The primary objective was to determine the association between ultrasonographic measurements and difficult intubation
Interventions
None listed
Sponsors
Kutahya Health Sciences University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 70 Years
Healthy volunteers
Yes
Inclusion criteria
* Age 18-70 years ASA physical status I-III Elective surgery under general anesthesia requiring orotracheal intubation Written informed consent
Exclusion criteria
* Refusal to participate Emergency surgery Pregnancy Known upper airway pathology or previous airway surgery Restricted mouth opening (\<3 cm) Cervical spine instability or significant limitation of neck mobility Morbid obesity (BMI ≥40 kg/m²) Obstructive upper airway masses (e.g., head and neck tumors) Prior neck radiotherapy Clinically relevant neck masses Major facial/mandibular trauma or craniofacial anomalies
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants with Difficult Intubation | During induction of anesthesia (intraoperative) | Difficult intubation was defined as requiring two or more intubation attempts (≥2 attempts) during induction of general anesthesia. |
| Number of Participants with Difficult Mask Ventilation | During induction of anesthesia (intraoperative) | Difficult mask ventilation was defined as the need for two-handed mask ventilation or inability to ventilate adequately using a face mask |
Countries
Turkey (Türkiye)
Contacts
PRINCIPAL_INVESTIGATORSerkan Telli, MD
Kutahya Health Sciences University
Outcome results
None listed