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Prediction of difficult laryngoscopy in obstetric patients scheduled for Caesarean delivery.
Eur J Anaesthesiol. 2008 Sep; 25(9):714-20.EJ

Abstract

BACKGROUND AND OBJECTIVE

Failed intubation is an important cause of anaesthetic-related maternal mortality. The purpose of this study was to determine the ability to predict difficult visualization of the larynx from the following preoperative airway predictive indices, in isolation and combination: modified Mallampati test, the ratio of height to thyromental distance and the Upper-Lip-Bite test.

METHODS

We collected data on 400 consecutive parturients scheduled for elective Caesarean delivery under general anaesthesia requiring endotracheal intubation and then assessed all three factors before surgery. An experienced anaesthesiologist, not apprised of the recorded preoperative airway assessment, performed the laryngoscopy and grading (as per Cormack and Lehane's classification). Sensitivity, specificity and positive predictive value for each airway predictor in isolation and in combination were determined.

RESULTS

Difficult laryngoscopy (Grade 3 or 4) occurred in 35 patients (8.75%). The ratio of height to thyromental distance had a higher sensitivity, positive predictive value and fewer false negatives than the other variables tested. The ratio of height to thyromental distance of 21.24 provided the best cut-off point for predicting subsequent difficult laryngoscopy. The odds ratio (95% CI) of the ratio of height to thyromental distance, Mallampati class and the Upper-Lip-Bite test were 127.8 (44.8-364.5), 49.8 (20.3-121.8) and 6.6 (2.29-19.30), respectively.

CONCLUSION

The ratio of height to thyromental distance may prove a useful screening test for predicting difficult laryngoscopy in obstetric population.

Authors+Show Affiliations

Department of Anesthesiology and Intensive Care, Isfahan University of Medical Sciences, Isfahan, Iran. honarmand@med.mui.ac.irNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18471331

Citation

Honarmand, A, and M R. Safavi. "Prediction of Difficult Laryngoscopy in Obstetric Patients Scheduled for Caesarean Delivery." European Journal of Anaesthesiology, vol. 25, no. 9, 2008, pp. 714-20.
Honarmand A, Safavi MR. Prediction of difficult laryngoscopy in obstetric patients scheduled for Caesarean delivery. Eur J Anaesthesiol. 2008;25(9):714-20.
Honarmand, A., & Safavi, M. R. (2008). Prediction of difficult laryngoscopy in obstetric patients scheduled for Caesarean delivery. European Journal of Anaesthesiology, 25(9), 714-20. https://doi.org/10.1017/S026502150800433X
Honarmand A, Safavi MR. Prediction of Difficult Laryngoscopy in Obstetric Patients Scheduled for Caesarean Delivery. Eur J Anaesthesiol. 2008;25(9):714-20. PubMed PMID: 18471331.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prediction of difficult laryngoscopy in obstetric patients scheduled for Caesarean delivery. AU - Honarmand,A, AU - Safavi,M R, Y1 - 2008/05/09/ PY - 2008/5/13/pubmed PY - 2008/12/17/medline PY - 2008/5/13/entrez SP - 714 EP - 20 JF - European journal of anaesthesiology JO - Eur J Anaesthesiol VL - 25 IS - 9 N2 - BACKGROUND AND OBJECTIVE: Failed intubation is an important cause of anaesthetic-related maternal mortality. The purpose of this study was to determine the ability to predict difficult visualization of the larynx from the following preoperative airway predictive indices, in isolation and combination: modified Mallampati test, the ratio of height to thyromental distance and the Upper-Lip-Bite test. METHODS: We collected data on 400 consecutive parturients scheduled for elective Caesarean delivery under general anaesthesia requiring endotracheal intubation and then assessed all three factors before surgery. An experienced anaesthesiologist, not apprised of the recorded preoperative airway assessment, performed the laryngoscopy and grading (as per Cormack and Lehane's classification). Sensitivity, specificity and positive predictive value for each airway predictor in isolation and in combination were determined. RESULTS: Difficult laryngoscopy (Grade 3 or 4) occurred in 35 patients (8.75%). The ratio of height to thyromental distance had a higher sensitivity, positive predictive value and fewer false negatives than the other variables tested. The ratio of height to thyromental distance of 21.24 provided the best cut-off point for predicting subsequent difficult laryngoscopy. The odds ratio (95% CI) of the ratio of height to thyromental distance, Mallampati class and the Upper-Lip-Bite test were 127.8 (44.8-364.5), 49.8 (20.3-121.8) and 6.6 (2.29-19.30), respectively. CONCLUSION: The ratio of height to thyromental distance may prove a useful screening test for predicting difficult laryngoscopy in obstetric population. SN - 1365-2346 UR - https://www.unboundmedicine.com/medline/citation/18471331/Prediction_of_difficult_laryngoscopy_in_obstetric_patients_scheduled_for_Caesarean_delivery_ L2 - https://doi.org/10.1017/S026502150800433X DB - PRIME DP - Unbound Medicine ER -