Sternomental Distance Ratio as a Predictor of Difficult Laryngoscopy: A Prospective, Double-Blind Pilot Study.
Airway
anesthesia
difficult airway
difficult laryngoscopy
sternomental distance ratio
Journal
Anesthesia, essays and researches
ISSN: 0259-1162
Titre abrégé: Anesth Essays Res
Pays: India
ID NLM: 101578762
Informations de publication
Date de publication:
Historique:
received:
08
01
2020
revised:
19
01
2020
accepted:
07
02
2020
entrez:
27
8
2020
pubmed:
28
8
2020
medline:
28
8
2020
Statut:
ppublish
Résumé
No single test has shown to be an accurate predictor of difficult laryngoscopy. This study aims to evaluate the effectiveness of the ratio of the sternomental distance (SMD) in neutral and full neck extension position SMD ratio (SMDR) as a predictor of difficult laryngoscopy and any need of assisted intubation. Prospective, double-blind pilot study. This study included 221 consecutive adult patients scheduled to undergo elective surgery under general anesthesia. Physical and airway characteristics, SMDR, difficult laryngoscopy (using Cormack/Lehane [C/L] scale), and any kind of assisted intubation were assessed. The optimal cutoff point for SMDR was identified using receiver operating characteristic (ROC) analysis. The association between SMDR and the intubation method was evaluated through multiple logistic regression analysis. A SMDR below 1.55 led in 33% of the cases to assisted intubation and 33%-53% of C/L III-IV glottic views for McCoy and Macintosh blades, respectively. On the other hand, SMDR above 1.9 led to no C/L IV glottic views for both blades and 4% and 11% C/L III views glottic views for McCoy and Macintosh, respectively. The best sensitivity and specificity cutoff point as defined by the ROC curve was identified for an SMDR value of 1.7 (area[s] under the curve: 0.815; 95% confidence interval: 0.743-0.887). Assisted intubation rates were significantly higher in patients with an SMDR inferior to 1.7 (30.5% compared to 3.5%, SMDR is a simple, objective, and easy to perform test. The present study indicates that SMDR may be helpful in predicting difficult laryngoscopy and assisted intubation.
Sections du résumé
BACKGROUND
BACKGROUND
No single test has shown to be an accurate predictor of difficult laryngoscopy.
AIMS
OBJECTIVE
This study aims to evaluate the effectiveness of the ratio of the sternomental distance (SMD) in neutral and full neck extension position SMD ratio (SMDR) as a predictor of difficult laryngoscopy and any need of assisted intubation.
SETTINGS AND DESIGN
METHODS
Prospective, double-blind pilot study.
MATERIALS AND METHODS
METHODS
This study included 221 consecutive adult patients scheduled to undergo elective surgery under general anesthesia. Physical and airway characteristics, SMDR, difficult laryngoscopy (using Cormack/Lehane [C/L] scale), and any kind of assisted intubation were assessed.
STATISTICAL ANALYSIS
METHODS
The optimal cutoff point for SMDR was identified using receiver operating characteristic (ROC) analysis. The association between SMDR and the intubation method was evaluated through multiple logistic regression analysis.
RESULTS
RESULTS
A SMDR below 1.55 led in 33% of the cases to assisted intubation and 33%-53% of C/L III-IV glottic views for McCoy and Macintosh blades, respectively. On the other hand, SMDR above 1.9 led to no C/L IV glottic views for both blades and 4% and 11% C/L III views glottic views for McCoy and Macintosh, respectively. The best sensitivity and specificity cutoff point as defined by the ROC curve was identified for an SMDR value of 1.7 (area[s] under the curve: 0.815; 95% confidence interval: 0.743-0.887). Assisted intubation rates were significantly higher in patients with an SMDR inferior to 1.7 (30.5% compared to 3.5%,
CONCLUSIONS
CONCLUSIONS
SMDR is a simple, objective, and easy to perform test. The present study indicates that SMDR may be helpful in predicting difficult laryngoscopy and assisted intubation.
Identifiants
pubmed: 32843792
doi: 10.4103/aer.AER_2_20
pii: AER-14-49
pmc: PMC7428112
doi:
Types de publication
Journal Article
Langues
eng
Pagination
49-55Informations de copyright
Copyright: © 2020 Anesthesia: Essays and Researches.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
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