Tags

Type your tag names separated by a space and hit enter

PREDICTION OF DIFFICULT INTUBATION BY USING UPPER LIP BITE, THYROMENTAL DISTANCE AND MALLAMPATI SCORE IN COMPARISON TO CORMACK AND LEHANE CLASSIFICATION SYSTEM
Wiad Lek. 2021; 74(9 pt 2):2305-2314.WL

Abstract

OBJECTIVE

To evaluate efficacy of Modified Mallampati test (MMT), upper lip bite test (ULBT) and Thyromental distance (TMD) or combination of two method Modified Mallampati test (MMT)+ upper lip bite test (ULBT), Thyromental distance (TMD) + upper lip bite test (ULBT) in prediction of difficult intubation in patients undergoing GA.

PATIENTS AND METHODS

Three tests were carried out in all patients by a single anesthesiologist. These were MMT, ULBT and TMD. Laryngoscopy was performed with patient's head in the sniffing position. The laryngoscopy view was graded according to modified Cormack and Lehane classification system. Study was prospective, single cross sectional, in 151 adult patients who required GA with endotracheal intubation for elective surgery. On arrival in the operating room, routine monitoring and venous cannula were introduced. Midazolam, Fentanyl. and rocuronium, ketamine , propofol were given to facilitate endotracheal intubation.

RESULTS

Out of 150 assessed patients, 18 (12%) had difficult intubation. Of those 18 patients, 17 (83.33%) patients had Cormack and Lehane classification III and one patient (16.67%) had classification IV. Compared with Cormack and Lehane classification system as the gold standard for difficult intubation, the sensitivity and specificity of MMT was 66.67% and 96.97% respectively, while ULBT had a sensitivity of 77.78% and a specificity of 93.18%, and TMD had a sensitivity of 55.56% and specificity of 94.97% respectively. A combination of different tests improved their efficiencies. The sensitivity and specificity MMT and TMD combinations was 77.78% and 92.42% respectively, while it was 88.89% and 93.18%, respectively for MMT and ULPT. The combination of TMD and ULBT has a sensitivity of 88.33% and a specificity of 91.67%.

CONCLUSION

Upper lip biting test has the best sensitivity while MMT had the best specificity. No single test alone can be reliable for predicting of difficult intubation. The combination of ULBT and MMT was the best in terms of both sensitivity and specificity for prediction of difficult intubation.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

34824177

Citation

Dawood, Ahmed Salam, et al. "PREDICTION of DIFFICULT INTUBATION BY USING UPPER LIP BITE, THYROMENTAL DISTANCE and MALLAMPATI SCORE in COMPARISON to CORMACK and LEHANE CLASSIFICATION SYSTEM." Wiadomosci Lekarskie (Warsaw, Poland : 1960), vol. 74, no. 9 pt 2, 2021, pp. 2305-2314.
Dawood AS, Talib BZ, Sabri IS. PREDICTION OF DIFFICULT INTUBATION BY USING UPPER LIP BITE, THYROMENTAL DISTANCE AND MALLAMPATI SCORE IN COMPARISON TO CORMACK AND LEHANE CLASSIFICATION SYSTEM. Wiad Lek. 2021;74(9 pt 2):2305-2314.
Dawood, A. S., Talib, B. Z., & Sabri, I. S. (2021). PREDICTION OF DIFFICULT INTUBATION BY USING UPPER LIP BITE, THYROMENTAL DISTANCE AND MALLAMPATI SCORE IN COMPARISON TO CORMACK AND LEHANE CLASSIFICATION SYSTEM. Wiadomosci Lekarskie (Warsaw, Poland : 1960), 74(9 pt 2), 2305-2314.
Dawood AS, Talib BZ, Sabri IS. PREDICTION of DIFFICULT INTUBATION BY USING UPPER LIP BITE, THYROMENTAL DISTANCE and MALLAMPATI SCORE in COMPARISON to CORMACK and LEHANE CLASSIFICATION SYSTEM. Wiad Lek. 2021;74(9 pt 2):2305-2314. PubMed PMID: 34824177.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - PREDICTION OF DIFFICULT INTUBATION BY USING UPPER LIP BITE, THYROMENTAL DISTANCE AND MALLAMPATI SCORE IN COMPARISON TO CORMACK AND LEHANE CLASSIFICATION SYSTEM AU - Dawood,Ahmed Salam, AU - Talib,Bashar Zuhair, AU - Sabri,Istabraq Sadoon, PY - 2021/11/26/entrez PY - 2021/11/27/pubmed PY - 2021/11/30/medline KW - Mallampati test KW - Upper lip biting KW - assessment to predict difficult intubation KW - thyromental distance SP - 2305 EP - 2314 JF - Wiadomosci lekarskie (Warsaw, Poland : 1960) JO - Wiad Lek VL - 74 IS - 9 pt 2 N2 - OBJECTIVE: To evaluate efficacy of Modified Mallampati test (MMT), upper lip bite test (ULBT) and Thyromental distance (TMD) or combination of two method Modified Mallampati test (MMT)+ upper lip bite test (ULBT), Thyromental distance (TMD) + upper lip bite test (ULBT) in prediction of difficult intubation in patients undergoing GA. PATIENTS AND METHODS: Three tests were carried out in all patients by a single anesthesiologist. These were MMT, ULBT and TMD. Laryngoscopy was performed with patient's head in the sniffing position. The laryngoscopy view was graded according to modified Cormack and Lehane classification system. Study was prospective, single cross sectional, in 151 adult patients who required GA with endotracheal intubation for elective surgery. On arrival in the operating room, routine monitoring and venous cannula were introduced. Midazolam, Fentanyl. and rocuronium, ketamine , propofol were given to facilitate endotracheal intubation. RESULTS: Out of 150 assessed patients, 18 (12%) had difficult intubation. Of those 18 patients, 17 (83.33%) patients had Cormack and Lehane classification III and one patient (16.67%) had classification IV. Compared with Cormack and Lehane classification system as the gold standard for difficult intubation, the sensitivity and specificity of MMT was 66.67% and 96.97% respectively, while ULBT had a sensitivity of 77.78% and a specificity of 93.18%, and TMD had a sensitivity of 55.56% and specificity of 94.97% respectively. A combination of different tests improved their efficiencies. The sensitivity and specificity MMT and TMD combinations was 77.78% and 92.42% respectively, while it was 88.89% and 93.18%, respectively for MMT and ULPT. The combination of TMD and ULBT has a sensitivity of 88.33% and a specificity of 91.67%. CONCLUSION: Upper lip biting test has the best sensitivity while MMT had the best specificity. No single test alone can be reliable for predicting of difficult intubation. The combination of ULBT and MMT was the best in terms of both sensitivity and specificity for prediction of difficult intubation. SN - 0043-5147 UR - https://www.unboundmedicine.com/medline/citation/34824177/PREDICTION_OF_DIFFICULT_INTUBATION_BY_USING_UPPER_LIP_BITE_THYROMENTAL_DISTANCE_AND_MALLAMPATI_SCORE_IN_COMPARISON_TO_CORMACK_AND_LEHANE_CLASSIFICATION_SYSTEM L2 - https://wiadlek.pl/wp-content/uploads/archive/2021/WLek202109211.pdf DB - PRIME DP - Unbound Medicine ER -