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Evaluation of Predictors for Difficult Laryngoscopy and Intubation in Pediatric Population

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Background: Airway management is very essential in medical speciality, difficulty in airway access can lead to hypoxic brain damage, cardiac arrest and even death or morbidity. A difficult airway in pediatric airway examination can be stressful condition for all involved. Hence in order to avoid the morbidity and mortality it is essential to evaluate airway in preoperative examination and identify potentially difficult airway. In order to find the predictors of difficult airway we conducted a study in 200 patients with age limit of 3-6 years scheduled for elective surgeries under general anesthesia. We studied the following tests: Interincisor distance (IID), MMC (Modified Mallampati classification), Thyromental distance (TMD) and CLG (Cormack Lehane Grade). We correlated EVL (easy visualization of larynx) CLG I, IIa, IIb and DVL (difficult visualization) CLG III, IV with above parameters. It was observed that there was no such difference in EVL and DVL with IID, MMC and TMD. While MMC-I showed statistically significant difference between EVL and DVL. Sensitivity of TMD was 84.69% and specificity was 98.5%. with MMC. Conclusion: Thyromental distance was good predictor for difficult laryngoscopy and intubation.

Perspectives

Background: Airway management is very essential in medical speciality, difficulty in airway access can lead to hypoxic brain damage, cardiac arrest and even death or morbidity. A difficult airway in pediatric airway examination can be stressful condition for all involved. Hence in order to avoid the morbidity and mortality it is essential to evaluate airway in preoperative examination and identify potentially difficult airway. In order to find the predictors of difficult airway we conducted a study in 200 patients with age limit of 3-6 years scheduled for elective surgeries under general anesthesia. We studied the following tests: Interincisor distance (IID), MMC (Modified Mallampati classification), Thyromental distance (TMD) and CLG (Cormack Lehane Grade). We correlated EVL (easy visualization of larynx) CLG I, IIa, IIb and DVL (difficult visualization) CLG III, IV with above parameters. It was observed that there was no such difference in EVL and DVL with IID, MMC and TMD. While MMC-I showed statistically significant difference between EVL and DVL. Sensitivity of TMD was 84.69% and specificity was 98.5%. with MMC. Conclusion: Thyromental distance was good predictor for difficult laryngoscopy and intubation.

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This page is a summary of: Evaluation of Predictors for Difficult Laryngoscopy and Intubation in Pediatric Population, Indian Journal of Anaesthesia and Analgesia, July 2020, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.7420.9.
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