This prospective observational study aims to evaluate the relationship between preoperative ultrasonographic airway measurements and the Video-Intubation Difficulty Assessment Classification (VIDIAC) score in adult patients undergoing endotracheal intubation under general anesthesia. The study will investigate whether airway ultrasound parameters can predict difficult videolaryngoscopic intubation and assess their association with the Cormack-Lehane classification, intubation time, and other airway management outcomes.
Difficult airway management is a major cause of anesthesia-related morbidity and mortality. Airway ultrasonography has emerged as a noninvasive tool for evaluating airway anatomy and may help predict difficult intubation. The Video-Intubation Difficulty Assessment Classification (VIDIAC) score is a recently developed and standardized method for assessing videolaryngoscopic intubation difficulty. This prospective, observational, single-center study aims to evaluate the relationship between preoperative ultrasonographic airway measurements and the VIDIAC score in adult patients undergoing elective surgery under general anesthesia. Ultrasonographic measurements, including tongue depth, tongue thickness, hyomental distance, hyoid depth, hyoid width, and distance from skin to epiglottis, will be obtained before anesthesia induction. Videolaryngoscopic intubation will be performed by anesthesiologists blinded to the ultrasound findings, and the VIDIAC score will be recorded. The study will assess the correlation between ultrasonographic airway measurements and the VIDIAC score, as well as the ability of these measurements to predict difficult videolaryngoscopic intubation.
Study Type
OBSERVATIONAL
Enrollment
100
To evaluate the relationship between preoperative ultrasonographic airway measurements and the VIDIAC score.
The relationship between preoperative ultrasonographic airway measurements and the Videolaryngoscopic Intubation and Difficult Airway Classification (VIDIAC) score will be evaluated in adult patients undergoing videolaryngoscopic intubation. The simplified VIDIAC score classifies patients as easy (-1 or 0), moderate (1), hard (2), or severe (≥3), with higher scores indicating greater videolaryngoscopic intubation difficulty. Correlations between ultrasonographic airway measurements and the VIDIAC score will be analyzed.
Time frame: During videolaryngoscopic intubation
Incidence of Difficult Videolaryngoscopic Intubation
The incidence of difficult videolaryngoscopic intubation will be determined using the Videolaryngoscopic Intubation and Difficult Airway Classification (VIDIAC) score. The simplified VIDIAC score is classified as follows: easy (-1 or 0), moderate (1), hard (2), and severe (≥3), with higher scores indicating greater videolaryngoscopic intubation difficulty. Patients classified as having difficult videolaryngoscopic intubation according to the predefined VIDIAC criteria will be identified, and the incidence will be calculated.
Time frame: During videolaryngoscopic intubation
Cormack-Lehane Grade
The Cormack-Lehane Grading System will be used to assess the laryngeal view obtained during videolaryngoscopic intubation. The scale ranges from Grade I to Grade IV (minimum: Grade I; maximum: Grade IV), where higher grades indicate poorer laryngeal visualization and greater difficulty with tracheal intubation. The recorded grade will be analyzed for its association with preoperative ultrasonographic airway measurements and the VIDIAC score.
Time frame: During videolaryngoscopic intubation
Intubation Time
The duration of videolaryngoscopic intubation, measured from insertion of the videolaryngoscope into the oral cavity until successful placement of the endotracheal tube.
Time frame: During videolaryngoscopic intubation
First-Attempt Intubation Success Rate
The proportion of patients successfully intubated on the first videolaryngoscopic attempt without the need for additional intubation attempts.
Time frame: During videolaryngoscopic intubation
Requirement for Additional Airway Maneuvers
The need for additional airway maneuvers during videolaryngoscopic intubation, including external laryngeal manipulation, repositioning, use of a bougie, stylet adjustment, or other adjunctive techniques to facilitate successful intubation.
Time frame: During videolaryngoscopic intubation
Occurrence of Oxygen Desaturation
The occurrence of oxygen desaturation during videolaryngoscopic intubation, defined as a decrease in peripheral oxygen saturation (SpO₂) below 90%.
Time frame: During videolaryngoscopic intubation
Number of Intubation Attempts
The total number of videolaryngoscopic intubation attempts required to achieve successful endotracheal intubation. An intubation attempt is defined as insertion of the videolaryngoscope into the oral cavity with the intention of placing the endotracheal tube.
Time frame: During videolaryngoscopic intubation
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