• Users Online: 258
  • Print this page
  • Email this page
Year : 2018  |  Volume : 1  |  Issue : 1  |  Page : 9-12

Bedside clinical tests as a screening tool for predicting difficult laryngoscopy and intubation: An observational study

1 Department of Anaesthesiology, Pramukhswami Medical College, Karamsad, Gujarat, India
2 Department of Anaesthesiology, Narayana Medical College and Hospital, Nellore, Andhra Pradesh, India
3 Central Research Services, Charutar Arogya Mandal, Anand, Gujarat, India

Correspondence Address:
Dr. Manoj Raju Prabandhankam
S/O Dr. P.S. Raju, Plot No. 16, SVU Non-teaching Colony, Opposite Vidyanagar Colony, Tirupati, Chittoor - 517 502, Andhra Pradesh
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ARWY.ARWY_6_18

Rights and Permissions

Context: Morphological characteristics of the airway in a population have regional variations making airway assessment and management a crucial aspect of anaesthesia practice. Aims: (1) To determine the incidence of difficult laryngoscopy and intubation using Cormack–Lehane grading and Intubation Difficulty Scale (IDS). (2) To assess the accuracy of bedside clinical tests in predicting difficult laryngoscopy and intubation. Settings and Design: Prospective observational study was carried out on 200 patients aged 18–70 years, undergoing planned surgical procedures under general anaesthesia requiring endotracheal intubation. Pregnant women, patients with head-and-neck pathology, and patients with trauma were excluded from the study. Patients and Methods: All patients underwent preoperative airway assessment and standard induction procedure. Cormack–Lehane grading was noted during first laryngoscopy and process of intubation evaluated by IDS. Statistical Analysis Used: Descriptive statistics used to depict baseline profile. Chi-square, Student t-test and logistic regression used to determine adjusted effects. Analysis was performed using STATA (14.2). Results: The incidence of difficult laryngoscopy was 15.5% and difficult intubation was 12.5%. Univariate analysis showed body mass index (BMI) >25 kg/m2, neck circumference (NC) >36 cm and modified Mallampati score 3/4 as significant predictors. Logistic regression showed interincisor gap (IIG) (P < 0.001) and NC (P < 0.001) as significant predictors. Conclusions: NC and IIG are rapid, simple bedside tests to predict difficult intubation. Bedside clinical tests have poor discriminative power but still have a role in choosing alternative methods for airway management, making judicious use of time and resources while causing minimum discomfort to the patient.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded431    
    Comments [Add]    

Recommend this journal