Prediction of Difficult Tracheal Videolaryngoscopic Intubation Using El-Ganzouri Risk Index

Abstract

Summary Introduction. Unanticipated difficult intubation still exists as a significant problem. El-Ganzouri risk index is a bedside difficult airway evaluation method, which can help determine risk of difficult airways. However, evidence of using of El-Ganzouri risk index in difficult laryngeal visualisation using videolaryngoscopes is limited. Aim of the Study. Determine the specificity and sensitivity of El-Ganzouri multivariate risk index to predict difficult laryngeal exposure using Storz C-MAC videolaryngoscope equipped with D type blade. Material and methods. We conducted a study of 29 patients, which were examined using El-Ganzouri risk index before induction of anaesthesia. After induction of anaesthesia videolaryngoscopy was performed using Storz C-MAC videolaryngoscope equipped with D-blade and laryngeal visualisation was graded using Cormack-Lehane scale. After laryngeal visualisation grading endotracheal tube insertion was performed and numbers of attempts as well as complications during intubation were recorded. Sensitivity, specificity, positive and negative predictive values were calculated, receiver operating characteristic curve and area under curve was obtained. Results. Sensitivity and specificity were 54.2% and 80.0% at El-Ganzouri risk index cut-off value of 2 points. Calculated positive predictive value was 26.7% and negative predictive value was 92.9%. Calculated AUC was 78.3%. Conclusions. El-Ganzouri risk index shows moderate sensitivity and specificity when used with Storz C-MAC videolaryngoscope. It can be used to predict difficult laryngeal visualization during videolaryngoscopic intubation.

Triad of safety, efficacy and patient comfort: videolaryngoscopic awake nasotracheal intubation using a lignocaine and propofol based technique

“…Once a BIS value of 65-70 was attained the infusion was discontinued and awake videolaryngoscopic nasotracheal intubation was attempted using a C-Mac D-blade videolaryngoscope. The first patient was a 50year old 57kg male with a restricted mouth opening, poor dentition and stiff neck post Commando surgery and radiotherapy (El Ganzouri Index (EGI) score: 9) 4 posted for flap revision and locoregional flap repair. During awake intubation, the cuff of the flexo-metallic cuffed endotracheal tube (FMCETT) had to be inflated with 3ml air to angulate it enough to reach the glottis.…”