The predictive value of the ratio of neck circumference to thyromental distance in comparison with four predictive tests for difficult laryngoscopy in obstetric patients scheduled for caesarean delivery
Identifieur interne : 001641 ( Main/Exploration ); précédent : 001640; suivant : 001642The predictive value of the ratio of neck circumference to thyromental distance in comparison with four predictive tests for difficult laryngoscopy in obstetric patients scheduled for caesarean delivery
Auteurs : Anahita Hirmanpour [Iran] ; Mohammadreza Safavi [Iran] ; Azim Honarmand [Iran] ; Mitra Jabalameli [Iran] ; Golnaz Banisadr [Iran]Source :
- Advanced Biomedical Research [ 2277-9175 ] ; 2014.
Abstract
Preoperative assessment of anatomical landmarks andclinical factors help detect potentially difficult laryngoscopies. The aim of the present study was to compare the ability to predict difficult visualization of the larynx from thefollowing preoperative airway predictive indices, in isolation and combination: Neck circumference to thyromental distance (NC/TMD), neck circumference (NC), modified Mallampatitest (MMT), the ratio of height to thyromental distance (RHTMD), and the upper-lip-bite test (ULBT).
We collected data on657 consecutive patients scheduled for elective caesarean delivery under general anesthesia requiring endotracheal intubation and then evaluated all five factors before caesarean. An experienced anesthesiologist, not informed of the recorded preoperative airway evaluation, performed the laryngoscopy and grading (as per Cormack and Lehane's classification). Sensitivity, specificity, and positive and negative predictive values for each airway predictor in isolation and in combination were determined.
Difficult laryngoscopy (Grade 3 or 4) occurred in 53 (8.06%) patients. There were significant differences in thyromental distance (TMD), RHTMD, NC, and NC/TMD between difficult visualization of larynx and easy visualization of larynx patients (
The NC/TM Discomparable with NC, RHTMD, and ULBT for the prediction of difficult laryngoscopy in caes are an delivery.
Url:
DOI: 10.4103/2277-9175.142045
PubMed: 25337530
PubMed Central: 4202503
Affiliations:
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">The predictive value of the ratio of neck circumference to thyromental distance in comparison with four predictive tests for difficult laryngoscopy in obstetric patients scheduled for caesarean delivery</title>
<author><name sortKey="Hirmanpour, Anahita" sort="Hirmanpour, Anahita" uniqKey="Hirmanpour A" first="Anahita" last="Hirmanpour">Anahita Hirmanpour</name>
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<wicri:regionArea>Department of Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan</wicri:regionArea>
<wicri:noRegion>Isfahan</wicri:noRegion>
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<author><name sortKey="Safavi, Mohammadreza" sort="Safavi, Mohammadreza" uniqKey="Safavi M" first="Mohammadreza" last="Safavi">Mohammadreza Safavi</name>
<affiliation wicri:level="1"><nlm:aff id="aff1">Department of Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff>
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<author><name sortKey="Jabalameli, Mitra" sort="Jabalameli, Mitra" uniqKey="Jabalameli M" first="Mitra" last="Jabalameli">Mitra Jabalameli</name>
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<author><name sortKey="Banisadr, Golnaz" sort="Banisadr, Golnaz" uniqKey="Banisadr G" first="Golnaz" last="Banisadr">Golnaz Banisadr</name>
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<series><title level="j">Advanced Biomedical Research</title>
<idno type="ISSN">2277-9175</idno>
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<imprint><date when="2014">2014</date>
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<front><div type="abstract" xml:lang="en"><sec id="st1"><title>Background:</title>
<p>Preoperative assessment of anatomical landmarks andclinical factors help detect potentially difficult laryngoscopies. The aim of the present study was to compare the ability to predict difficult visualization of the larynx from thefollowing preoperative airway predictive indices, in isolation and combination: Neck circumference to thyromental distance (NC/TMD), neck circumference (NC), modified Mallampatitest (MMT), the ratio of height to thyromental distance (RHTMD), and the upper-lip-bite test (ULBT).</p>
</sec>
<sec id="st2"><title>Materials and Methods:</title>
<p>We collected data on657 consecutive patients scheduled for elective caesarean delivery under general anesthesia requiring endotracheal intubation and then evaluated all five factors before caesarean. An experienced anesthesiologist, not informed of the recorded preoperative airway evaluation, performed the laryngoscopy and grading (as per Cormack and Lehane's classification). Sensitivity, specificity, and positive and negative predictive values for each airway predictor in isolation and in combination were determined.</p>
</sec>
<sec id="st3"><title>Results:</title>
<p>Difficult laryngoscopy (Grade 3 or 4) occurred in 53 (8.06%) patients. There were significant differences in thyromental distance (TMD), RHTMD, NC, and NC/TMD between difficult visualization of larynx and easy visualization of larynx patients (<italic>P</italic>
< 0.05). The main end-point area under curve (AUC) of the receiver-operating characteristic (ROC) was lower for MMT (AUC = 0.497; 95% Confidence Interval = CI,0.045-0.536) and ULBT (AUC = 0.500, 95% CI, 0.461-0.539) compared to RHTMD, NC, TMD, and NC/TMD score ([AUC = 0.627, 95% CI, 0.589-0.664], [AUC = 0.691; 95% CI, 0.654-0.726], [AUC = 0.606; 95% CI, 0.567-0.643], [AUC = 0.689;95% CI, 0.625-0.724], respectively), and the differences of six ROC curves were statistically significant (<italic>P</italic>
< 0.05).</p>
</sec>
<sec id="st4"><title>Conclusion:</title>
<p>The NC/TM Discomparable with NC, RHTMD, and ULBT for the prediction of difficult laryngoscopy in caes are an delivery.</p>
</sec>
</div>
</front>
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<author><name sortKey="Van Groeningen, D" uniqKey="Van Groeningen D">D van Groeningen</name>
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<author><name sortKey="Brock Utne, Jg" uniqKey="Brock Utne J">JG Brock-Utne</name>
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<author><name sortKey="Vierra, M" uniqKey="Vierra M">M Vierra</name>
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<affiliations><list><country><li>Iran</li>
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<name sortKey="Banisadr, Golnaz" sort="Banisadr, Golnaz" uniqKey="Banisadr G" first="Golnaz" last="Banisadr">Golnaz Banisadr</name>
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