Background The study was conducted with the aim of determining the usefulness of ultrasonography in assessment of difficult airway preoperatively to compare and correlate airway assessment done clinically and airway viewed ultra sonographically with Cormack–Lehane classification of the direct laryngoscopy. Methodology This prospective, observational trial consists of total 150 patients undergoing elective surgeries under general anesthesia. The measurements recorded were interincisor gap, modified Mallampati's classification, and thyromental distance and the airway assessment of ultrasound done. Based on the Cormack–Lehane classification of laryngoscopic view, patients were classified into different groups: group A—easy intubation and group B—difficult intubation, at the end of the study. Results In both the groups, demographic data were similar except weight, which was significant in group B. Ultrasound measurements of airway done at four levels—hyoid bone, suprasternal-notch, thyroid isthmus, and thyroid—were increased in group B compared with group A, with p-values 0.0002, 0.0001, 0.001, and 0.0001, respectively, showing significant results. Conclusion On the basis of our study, we conclude that by measuring the thickness of soft tissues in the anterior part of neck with ultrasound difficult airway can be predicted, thus ultrasound can be used for assessing difficult airway preoperatively.
Objective Ultrasound-guided supraclavicular brachial plexus block is a popular anesthetic technique for upper limb surgeries. Assessing the success sensory and motor block using conventional methods is time consuming and also it needs patient co-operation. In the present study, objective method like increase in perfusion index is used to predict the success of ultrasound-guided supraclavicular block. Materials and Methods This prospective trial consists of total 95 patients undergoing elective upper limb procedures. All patients received ultrasound-guided supraclavicular block using 0.5% bupivacaine 20 mL. Sensory and motor blocks were evaluated every 5 minutes followed by pinprick testing and ability to flex the elbow and the hand against gravity, respectively. The perfusion index was measured using pulse oximetry applied on the index finger and recorded at baseline and 10, 20, and 30 minutes interval after local anesthetic injection in both the blocked limb and the contralateral unblocked limb using two separate pulse oximeters. Results Perfusion index increased in blocked arm after 5 minutes compared with unblocked arm and also to its baseline value. Both perfusion index and perfusion index ratio in blocked arm were found statistically significant. Conclusion To evaluate the success of supraclavicular block, perfusion index can be considered as a useful tool.
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