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Clinical comparison of five different predictor tests for difficult intubation.

Author(s)
Vaijayanti Kishor Badhe Department of Anesthesiology and Critical Care, Pravara Institute of Medical Sciences, Loni-41 3736, India
Shrikrishna Govind Deogaonkar Department of Anesthesiology and Critical Care, Pravara Institute of Medical Sciences, Loni-41 3736, India
Mahendra Vilasrao Tambe Department of Anesthesiology and Critical Care, Pravara Institute of Medical Sciences, Loni-41 3736, India
Abhishek Singla Department of Anesthesiology and Critical Care, Pravara Institute of Medical Sciences, Loni-41 3736, India
Ramchandra Vinayak Shidhaye Department of Anesthesiology and Critical Care, L.N. Medical College & J.K Hospital, Kolar Road, Bhopal, India
Abstract
 The objective of this study was to compare various bedside tests including Modified Mallampati Test (MMT), thyro mental distance (TMD), sternomental distance (SMD), Inter Incisor Gap (JIG) and combination of the modified Mallampati test and thyromental distance for predicting difficult intubation. Methodology: A cross sectional study was conducted on 301 nonobese patients (18-72 years of age) without obvious airway pathology. All patients belonged to the American Society of Anesthesiology (ASA) class 1 or 2 and were scheduled for elective surgery that required general anesthesia. Airway assessment was performed and the appropriate scores were assigned for each predictor test. Difficult intubation was defined as Grade III or IV based on the Cormack- Lehane classification on laryngoscopic view. Results: All tests except TMD (71.43%) showed very poor sensitivity and very high specificity. Area under the curve was good (0.8 to 0.9) for all the tests. Posttest probability showed that all of the bedside tests have limited clinical value. Conclusion: All four predictor tests for difficult intubation have only poor to moderate discriminative power when used alone. Combination of Modified Mallampati and Thyromental distance test adds some incremental diagnostic value in comparison to the value of each test alone.
Publication Details
Page(s) 31-37
DOI DOI not available
Published Journal: Anaesthesia, Pain and Intensive Care, Volume: 18, Issue: 1, Year: 2014

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