Background:Various anatomical measurements and noninvasive clinical tests, singly or in various combinations can be performed to predict difficult intubation. Upper lip bite test (ULBT) and ratio of height to thyromental distance (RHTMD) are claimed to have high predictability. Hence, we have conducted this study to compare the predictive value of ULBT and RHTMD with the following parameters: Mallampati grading, inter-incisor gap, thyromental distance, sternomental distance, head and neck movements, and horizontal length of mandible for predicting difficult intubation.Materials and Methods:In this single blinded, prospective, observational study involving 170 adult patients of either sex belonging to American Society of Anesthesiologists physical Status I–III scheduled to undergo general anesthesia were recruited. All patients were subjected to the preoperative airway assessment and, the above parameters were recorded correlated with Cormack and Lehane grade and analyzed. The number of intubation attempts and use of intubation aids were also noted.Results:ULBT and RHTMD had highest sensitivity (96.64%, 90.72%), specificity (82.35%, 80.39%), positive predictive value (92.74%, 91.53%), and negative predictive value (91.3%, 78.8%), respectively, compared to other parameters. While odds ratio and likelihood ratio >1 for all the tests.Conclusion:ULBT can be used as a simple bedside screening test for prediction of difficult intubation, but it should be combined with other airway assessment tests for better airway predictability. RHTMD can also be used as an acceptable alternative.
Background:The LMA-Proseal TM is a second generation supraglottic airway device with modified cuff and a drainage tube, designed for better seal with both the respiratory and gastrointestinal tracts, notwithstanding the access to the alimentary tract. The present study is planned to compare efficacy of the LMA-Classic TM and LMA Proseal TM in children undergoing elective surgery under general anaesthesia. Subjects and Methods: 120 children belonging to American Society of Anesthesiologists Physical Status 1 and 2, aged 3 to 15 years and weighing 5 to 45 kg undergoing elective surgery in the supine position were randomized for airway management with the LMA-Classic TM or LMAProseal TM by computer-generated random assignments. Results: There was no difference between LMA Classic TM and LMA Proseal TM with regard to ease of insertion, number of attempts for insertion, device positional stability, airway trauma and hemodynamic changes. Conclusion: The LMA-ProsealTM has advantages over LMA-Classic TM like the placement of gastric tube, adequate ventilation and oxygenation without any gastric distension. The complications of usage of the LMA are minimal and similar in both the devices.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.