Comparison and evaluation of various bedside tests to predict difficult endotracheal intubation.
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Date
2016
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Abstract
Introduction: As difficult laryngoscopy is a multifactorial problem, therefore any preoperative
assessment of difficult tracheal intubation should have high sensitivity and specificity and result in
minimal false positive and false negative values. This study was conducted in an attempt to devise a
method of predicting difficult intubation and to assess the reliability of six simple bedside tests to predict
difficult intubation.
Material and Methods: This double blind prospective study involved 100 adult patients posted for
elective surgery under general anesthesia. The airways were assessed for modified Mallampati test,
Thyromental Distance, Sternomental Distance, Inter incisor gap; Atlanto-Occipital joint extension and
Upper Lip bite Test. The laryngoscopic view and difficulty of intubation were noted. The sensitivity,
specificity, positive and negative predictive values were calculated.
Results: No method either individual or in combination with others had 100% sensitivity. The Modified
Mallampati test had 76% sensitivity. Upper Lip bite Test had 98.66% specificity. The combination of
Modified Mallampati test and Inter incisor gap had 52% sensitivity and 86.66% specificity.
Conclusion: The “composite intubation difficulty score” is an easy and reliable method of predicting
difficult intubation.
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Keywords
Mallampati test, Thyromental Distance, Sternomental Distance, Inter incisor gap, Atlanto-Occipital joint extension and Upper Lip bite Test
Citation
Mall Krishna Pratap, Rai Sujit, Sharma Rashmi, Gangwar Richa. Comparison and evaluation of various bedside tests to predict difficult endotracheal intubation. National Journal of Medical and Allied Sciences. 2016; 5(2): 91-96.