Assessment of Airway in Patients with Acromegaly Undergoing Surgery: Predicting Successful Tracheal Intubation
Background In the field of anesthesia, acromegaly is considered a cause of difficult tracheal intubation and airway management. There is a high probability of unanticipated difficult intubation in acromegalic patients despite a lower percentage of patients being identified preoperatively as having a...
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doaj-4a79a0f0fe5b43a2ab92faf5b34c05252021-05-13T22:32:10ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Neuroanaesthesiology and Critical Care2348-05482348-926X2021-03-01080104004410.1055/s-0039-1692550Assessment of Airway in Patients with Acromegaly Undergoing Surgery: Predicting Successful Tracheal IntubationIndu Kapoor0Charu Mahajan1Hemanshu Prabhakar2Department of Neuroanaesthesiology and Critical Care, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Neuroanaesthesiology and Critical Care, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, IndiaDepartment of Neuroanaesthesiology and Critical Care, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, IndiaBackground In the field of anesthesia, acromegaly is considered a cause of difficult tracheal intubation and airway management. There is a high probability of unanticipated difficult intubation in acromegalic patients despite a lower percentage of patients being identified preoperatively as having a difficult airway. In this study, we carried out various airway assessment tests preoperatively and during induction of anesthesia to find out the predictors of easy tracheal intubation in patients with acromegaly. Methods All patients of either sex, diagnosed as a case of acromegaly and scheduled to undergo pituitary surgery were enrolled over a period of 3 years. Various airway assessment tests were performed prior to surgery, which included modified Mallampati (MP) classification (sitting and supine), mouth opening (MO), upper lip bite test (ULBT), neck movement (NM), thyromental (TM) distance, thyrohyoid (TH) distance, sternomental (SM) distance, hyomental (HM) distance, length of upper incisors (IL), receding mandible (RM), any history of obstructive sleep apnea (OSA), mask ventilation (MV), Cormack-Lehane (CL) III and IV, and external laryngeal manipulation (ELM). Results were reported as odds ratios (95% confidence interval [CI]). The p-value < 0.05 was considered statistically significant. Results A total of 42 patients were enrolled over a period of 3 years. The male-to-female ratio was 19:23 with a mean age of 37.95 years and mean weight of 72.7 kg. Out of 15 airway assessment parameters, only ULBT and CL grade showed significant results. Conclusion We conclude that ULBT and CL grading are reliable predictors of easy intubation in patients with acromegaly undergoing surgery.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1692550acromegalyairwayintubation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Indu Kapoor Charu Mahajan Hemanshu Prabhakar |
spellingShingle |
Indu Kapoor Charu Mahajan Hemanshu Prabhakar Assessment of Airway in Patients with Acromegaly Undergoing Surgery: Predicting Successful Tracheal Intubation Journal of Neuroanaesthesiology and Critical Care acromegaly airway intubation |
author_facet |
Indu Kapoor Charu Mahajan Hemanshu Prabhakar |
author_sort |
Indu Kapoor |
title |
Assessment of Airway in Patients with Acromegaly Undergoing Surgery: Predicting Successful Tracheal Intubation |
title_short |
Assessment of Airway in Patients with Acromegaly Undergoing Surgery: Predicting Successful Tracheal Intubation |
title_full |
Assessment of Airway in Patients with Acromegaly Undergoing Surgery: Predicting Successful Tracheal Intubation |
title_fullStr |
Assessment of Airway in Patients with Acromegaly Undergoing Surgery: Predicting Successful Tracheal Intubation |
title_full_unstemmed |
Assessment of Airway in Patients with Acromegaly Undergoing Surgery: Predicting Successful Tracheal Intubation |
title_sort |
assessment of airway in patients with acromegaly undergoing surgery: predicting successful tracheal intubation |
publisher |
Thieme Medical and Scientific Publishers Pvt. Ltd. |
series |
Journal of Neuroanaesthesiology and Critical Care |
issn |
2348-0548 2348-926X |
publishDate |
2021-03-01 |
description |
Background In the field of anesthesia, acromegaly is considered a cause of difficult tracheal intubation and airway management. There is a high probability of unanticipated difficult intubation in acromegalic patients despite a lower percentage of patients being identified preoperatively as having a difficult airway. In this study, we carried out various airway assessment tests preoperatively and during induction of anesthesia to find out the predictors of easy tracheal intubation in patients with acromegaly.
Methods All patients of either sex, diagnosed as a case of acromegaly and scheduled to undergo pituitary surgery were enrolled over a period of 3 years. Various airway assessment tests were performed prior to surgery, which included modified Mallampati (MP) classification (sitting and supine), mouth opening (MO), upper lip bite test (ULBT), neck movement (NM), thyromental (TM) distance, thyrohyoid (TH) distance, sternomental (SM) distance, hyomental (HM) distance, length of upper incisors (IL), receding mandible (RM), any history of obstructive sleep apnea (OSA), mask ventilation (MV), Cormack-Lehane (CL) III and IV, and external laryngeal manipulation (ELM). Results were reported as odds ratios (95% confidence interval [CI]). The p-value < 0.05 was considered statistically significant.
Results A total of 42 patients were enrolled over a period of 3 years. The male-to-female ratio was 19:23 with a mean age of 37.95 years and mean weight of 72.7 kg. Out of 15 airway assessment parameters, only ULBT and CL grade showed significant results.
Conclusion We conclude that ULBT and CL grading are reliable predictors of easy intubation in patients with acromegaly undergoing surgery. |
topic |
acromegaly airway intubation |
url |
http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1692550 |
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