Wolff–Parkinson–White syndrome (WPW) is an uncommon cardiac disorder having an aberrant pathway between atria and ventricles. We are reporting a known case of WPW syndrome for hysterectomy under combined spinal epidural anaesthesia. Management of the present case is an important pearl to revisit management of WPW syndrome. The perioperative management should be tailored according to the nature of surgery and the clinical presentation of the patient.
Background and Objectives:Patient identification with difficult intubation is important in planning anesthetic management and one major factor for difficult intubation in the obese patients is large neck circumference. The need for prediction of a potentially difficult airway received great importance as it plays a significant role in reducing morbidity and mortality. Therefore, this study was done to glimpse the effect of neck circumference on endotracheal intubation and to determine the frequency of difficult intubation.
Material and Methods:The study was cross sectional descriptive study and convenient sampling technique was used. Seventy patients of age between 19-50 years of both sexes were enrolled. Neck circumference was measured at the level of cricoid cartilage along with other airway assessments. Direct laryngoscopy was done and checked whether it is difficult one or easy using Intubation difficulty scale. Data were entered and analyzed by using statistical software SPSS version 15.0.
Results:Mean BMI was noted as 33.02±2.30 kg/m2 and the mean neck circumference was 43.64±2.30 cm. Difficult intubation was observed in 23 (32.86%) patients with mean neck circumference of 45.44±1.88 cm and normal intubation observed in 47(67.14%) patients with mean neck circumference of 42.77±1.98 cm. Linear correlation was found between the neck circumference and Intubation Difficulty Scale score with value of Pearson correlation=0.617.
Conclusion:Neck circumference of patient was found to have significant effects on difficult intubation. Frequency of difficult intubation was found in almost one third of obese patients with increasing neck circumference.
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