Magnitude and Predictive Values of Preoperative Tests for Difficult Laryngoscopy and Intubation Among Surgical Patients who Underwent Elective Surgery Under General Anesthesia in Tikur Anbessa Specialized Hospital From February1 to March 30, 2016
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Date
2016-06
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Addis Abeba University
Abstract
Introduction: The significance of difficult or failed tracheal intubation following induction is
well-recognized cause of morbidity and mortality in anesthetic practice. Nevertheless, the need
to predict potentially difficult tracheal intubation has received a little attention. During routine
anesthesia the incidence of difficult tracheal intubation has been estimated at 1.5% - 8% of
general anesthetics. Difficulties in intubation have been associated with serious complications,
such as brain damage or death, particularly when failed intubation has occurred. Occasionally in
a patient with a difficult airway, the anesthetist is faced with the situation where mask ventilation
proves difficult or impossible. This is one of the most critical emergencies that may be faced in
the practice of anesthesia. If the anesthetist can predict which patients are likely to prove difficult
to intubate, he/she may reduce the risks of anesthesia considerably. In Ethiopia there is no data
on the magnitude of difficult laryngoscopic tracheal intubation and no standard guideline for
preoperative tests.The main concern of this study was to provide information on the magnitude
of difficult laryngoscopic intubation and to determine valuable preoperative tests to predict
difficult laryngoscopy and intubation in patients with apparently normal airways which can help
anesthetists to improve preoperative airway assessment and contribute to decrease anesthesia
related morbidity and mortality.
Objective:The main objective of this study was to assess the magnitude and predictive values of
preoperative tests for difficult laryngoscopy and intubation, among surgical patients who
underwent elective surgery under general anesthesia with endotracheal intubation in Tikur
Anbessa Hospital from February 1- March 30, 2016.
Study design: A facility based cross sectional study design was used.
Result:In this study, we found the magnitude of difficult laryngoscopy and intubation as 13.6%
and 5% respectively. 33.3% of Patients with difficult laryngoscopy were found to be difficult for
intubation. Mallampatti test, interincisor distance and thyromental distance were identified to be
good preoperative tests to predict difficult laryngoscopic intubation when used in combination.
Recommendation: We recommend anesthesia professionals to use combination of
MMC/TMD/IID for their routine preoperative airway assessmen
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Tikur Anbessa Specialized Hospital