Use of Simple Clinical Predictors on Preoperative Diagnosis of Difficult Endotracheal Intubation in Obese Patients

Abstract

The clinical and polysomnographic diagnosis of OSA proved useful in the preoperative diagnosis of difficult laryngoscopy. Obese patients are more prone to difficult facemask ventilation and laryngoscopy.

Morphometric and ultrasonographic determinants of difficult laryngoscopy in obese patients: A prospective observational study

“…compared with those of our study and others. 8,11,14,16 Moreover, our results suggested that neither BMI nor modified Mallampati score were correlated with difficult laryngoscopy, contrasting with some previous studies 6–8 but agreeing with others. 9–12 Eiamcharoenwit et al reported that neck circumference and modified Mallampati score show limited predictive performance for difficult intubation among obese parturients.…”

“…6–16 Differences in the measurements and definitions of difficult airway and the evaluated airway characteristics are potentially responsible for the discrepancies in previous findings. We found that greater neck circumference was linked to difficult laryngoscopy, in line with some previous studies 8,11,14 but not the study by Magalhaes et al 16 This might be explained by the significantly lower BMI and neck circumference in the study by Magalhaes et al . compared with those of our study and others.…”

“…Although obese patients have a higher risk of difficult laryngoscopy, there is still no definite predictor in the current literature due to conflicting results in previous studies. [6][7][8][9][10][11][12][13][14][15][16] Differences in the measurements and definitions of difficult airway and the evaluated airway characteristics are potentially responsible for the discrepancies in previous findings. We found that greater neck circumference was linked to difficult laryngoscopy, in line with some previous studies 8,11,14 but not the study by Magalhaes et al 16 This might be explained by the significantly lower BMI and neck circumference in the study by Magalhaes et al compared with those of our study and others.…”

“…8,11,13,14 By contrast, other studies showed no association between neck circumference, anterior neck soft tissue depth, and difficult laryngoscopy. 15,16 The results of previous studies were mixed and inconclusive due to the inconsistent and incomprehensive evaluations of airway characteristics which are potentially related to difficult laryngoscopy. [6][7][8][9][10][11][12][13][14][15][16] In addition, the predictive role of ultrasonographic airway measures for difficult laryngoscopy has been rarely explored in obese populations.…”

“…15,16 The results of previous studies were mixed and inconclusive due to the inconsistent and incomprehensive evaluations of airway characteristics which are potentially related to difficult laryngoscopy. [6][7][8][9][10][11][12][13][14][15][16] In addition, the predictive role of ultrasonographic airway measures for difficult laryngoscopy has been rarely explored in obese populations. 13,15 We conducted a prospective observational study to explore potential risk factors for difficult laryngoscopy in obese patients undergoing bariatric surgery.…”