Evaluating the success of measurements taken with ultrasound airway imaging in predicting difficult intubation by comparing conventional parameters in terms of difficult intubation and the proportion of patients encountered during intubation and characterised as difficult.
Clinical screening tests, which have long been routinely used for airway assessment, do not have sufficient sensitivity and specificity to detect difficult laryngoscopy. The Cormack-Lehane laryngoscopy classification, which can be assessed during direct laryngoscopy, is an invasive procedure and is not suitable for routine preoperative airway assessment. Preoperative airway assessment using ultrasound can help to predict a difficult laryngoscopy and/or difficult intubation and is growing in popularity as a non-invasive diagnostic tool. Several recent studies have emphasised the importance of various ultrasound-mediated airway measurements in predicting difficult intubation, and have shown that measurements with different parameters and data obtained by ratioing some measurements to each other may have an important role. However, the parameters obtained by ultrasound-mediated airway measurement can help determine airway anatomy and guide airway interventions with dynamic real-time images. In this study, investigators used hyoid bone visibility obtained through preoperative ultrasound evaluation of the upper airway, followed by measurements of the skin-hyoid distance, skin-cricothyroid membrane distance and length, and hyomental distance in two different positions-neutral and extension. The ratios of these measurements were analyzed to predict difficult intubation. Traditional parameters commonly used as indicators of difficult ventilation and/or intubation, such as the Mallampati-Samsoon classification, upper lip bite test, thyromental distance, sternomental distance, neck circumference, maximum mouth opening, Wilson difficult intubation score, and Han ventilation scale, were also included in the study.
Study Type
OBSERVATIONAL
Enrollment
420
no interventions will be performed by the research team
Ankara Ataturk Sanatorium Research and Training Hospital
Ankara, Turkey (Türkiye)
Ratio of ultrasound-derived parameters with conventional parameters
ultrasound derived parameters: hyoid bone visibility, skin-hyoid distance, skin-hyoid distance, skin-crricothyroid membrane distance, cricothyroid membrane length and hyomental distance measured in neutral and extension and the ratio of these values. Conventional parameters: thyromental distance, sternomental distance, upper lip bite test, head-neck movement, presence of retrognathia, neck circumference, maximum mouth opening, Wilson difficult intubation score, Han scale and Mallampati score
Time frame: 1 hour peroperatively
Incidence of difficult intubation
Defined as ≥3 intubation attempts by an experienced anesthesiologist, use of adjunctive devices (e.g., stylet, LMA, video laryngoscope), or duration \>10 minutes.
Time frame: 1 hour peroperatively
Incidence of difficult ventilation
Grade 3 and 4 for Han scale.( Difficulty of mask ventilation (DMV) has been classified using the Han scale.)
Time frame: 1 hour preoperatively
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