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.

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