Magnitude and Associated Factors of Difficult Airway in Adult Patients Who Underwent Elective Maxillofacial Operation with Endotracheal Intubation at Selected Public Hospitals, Addis Ababa, Ethiopia, 2021: Cross-sectional study.
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Date
2021-06
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Addis Abeba University
Abstract
Background: Difficult airway is a phenomenon in which there is a problem in maintaining gas exchange
via a mask, an artificial airway or both. Degree of difficulty is associated with patient‟s airway anatomy
and health status, clinical settings, surgical procedures that are being performed and experience of the
practitioner. It results morbidity and mortality specifically in developing countries where equipment that
aids for difficult airway management is not accessible.
Objective: To assess magnitude and associated factors of difficult airway in adult patients who
underwent elective maxillofacial operation with endotracheal intubation at selected public hospitals,
Addis Ababa, Ethiopia, 2021: A cross-sectional study.
Methods: A cross-sectional study was conducted from January 22/2021 to May 21/2021 on 208
participants at three selected public hospitals in Addis Ababa that provide maxillofacial surgery.
Hospitals were selected purposively. A review of logbook showed that 216 patients underwent surgery in
four consecutive months before data collection process. Actual study participants who met inclusion
criteria were (n = 208). Data were analyzed using SPSS version 24. Binary and multivariate logistic
regression were used to measure association between the factors and outcomes at 95% CI using AOR. P
value below 0.05 was considered as statistical significance.
Results: A total of 208 participants were investigated. We found that magnitude of difficult airway, difficult
laryngoscopy, difficult intubation, difficult mask ventilation and failed intubation were 23.1%, 17.8%, 16.3%,
5.3 and 0.96% respectively, but there were no cases with „Can‟t Ventilate Can‟t Intubate‟ situation. Upper lip
bite test class III, oropharyngeal view class IV, sternomental distance below 12cm, thyromental distance
below 6cm, body mass index above 30kg
, age above 55 years and history of snoring were an
independent predisposing factors for difficult airway.
Conclusion and Recommendations: The extent of the problem was considerably high; thus, we
recommend anesthesia providers and hospital administrators to give emphasis. Availability of fully
equipped facilities, appropriate use of alternative techniques and laryngeal manipulation are highly
recommended to decrease the incidence.
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Keywords
Difficult airway; Maxillofacial surgery, Associated factors.