Assessment of predictors for difficult intubation and laryngoscopy in adult elective Surgical Patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2019

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Addis Ababa University


Background: General anesthesia is not without Morbidity. One of the well-known life threatening events associated with general anesthesia is difficult airway which can happen during induction of anesthesia while attempting to insert the endotracheal tube with the aid of laryngoscope. Difficult intubation, inadequate ventilation and esophageal intubation are the principal causes of death or brain damage related to airway manipulation Objective: The main objective of this study was to assess predicators for difficult laryngoscopy and intubation, among surgical patients who underwent elective surgery under general anesthesia with endotracheal intubation in Tikur Anbessa Hospital from February 4 to March 29, 2019 Materials &methods: After the Ethical Committee approval, Institutional based cross sectional study was be conduct from February 1 to March 30, 2019 on patients submitted to TASH major operation room undergoing surgery under general anesthesia with endotracheal intubation (ETT). Patients were evaluated during preanesthetic bed side tests on the Mallampati classification, and the American Society of Anesthesiologists (ASA) difficult airway algorithm .Data on socio demographic characteristics, preanesthetic airway assessment & laryngoscopic view was collected. Data were analyzed by SPSS Version 20.0 window. In the study population. Descriptive as well as analytic statistics was used for variables and data presented by tables, graphs, charts, and texts. Independent variables with the dependent variable; was analyzed by using chi- square test, , binary logistic regression, and ROC curve were performed and p value less than 0.05 was taken as strong association Results; The magnitude of difficult laryngoscopy, difficult intubation, and failed intubation are 15.2%, 6.1%, and 0.07%, respectively. IID < 30mm and Mallampati classes III and IV are the most sensitive tests and to predict difficult intubation and laryngoscopy (value < 0.001).Unrestricted multiple attempt increases further difficulty of airway management ( value < 0.001) Conclusion and recommendation: In spite of various airway assessment tests, no single test was 100% accurate. We would like to recommend anesthesia professionals to use the combination of as their routine preoperative tests to predict difficult laryngoscopy and intubation.



Intubation ,laryngoscopy,Surgical Patients