PREDICTORS OF DIFFICULT AIRWAY

With the rapid advancement of anesthesia-related technologies, innovative devices such as video laryngoscopes and supraglottic airway devices (SGAs) have signicantly enhanced the efciency and safety of airway management for anesthesiologists and other healthcare providers. Despite these technological breakthroughs, managing difcult airways remains a critical challenge in clinical practice. A difcult airway is dened as a situation in which experienced professionals encounter challenges in ventilation using face masks or in performing tracheal intubation with standard tools such as stylets. The consequences of such difculties can be severe—unconscious patients may experience inadequate oxygenation, potentially leading to irreversible brain injury or even death. The ability to accurately predict the likelihood of a difcult airway before surgery is essential. It allows anesthesiologists to make thorough preoperative preparations and be equipped to act swiftly should airway complications arise. To address this need, a variety of predictive methods have been proposed. These strategies aim to improve the identication of at-risk patients, enhance clinical decision-making, and ultimately reduce the incidence of airway-related complications during anesthesia. Objectives: To study preoperative prediction methods for difcult tracheal intubation in adult patients undergoing various surgical procedures under General anesthesia. Materials And Methods: It is a prospective observational study of 60 patients with ASA physical status 1-2 patients, aged 19-70 years, who underwent elective surgery with endotracheal intubation were included.. During the pre-anesthetic visit, patients were evaluated by 7 preoperative airway assessment factors, including the following: Mallampati classication, thyromental distance, head & neck movement, body mass index (BMI), buck teeth, inter-incisor gap, and upper lip bite test (ULBT). After endotracheal intubation, patients were divided into 2 groups based on their Intubation difculty scale (IDS) score estimated with 7 variables: normal (IDS < 5) and DI (IDS ≥ 5) groups. The incidence of Total airway score (> 6) and high score of each airway assessment factor was compared in two groups: odds ratio, condence interval (CI) of 95%, with a signicant P value ≤ 0.05. Results:Among the total 60 patients, in the difcult intubation (DI) group, which had an IDS > 5, there were 7 patients (11.8%); in the normal (N) group, which had IDS ≤ 5, there were 53 patients (88.2%). There were no failures of intubation in patients with IDS≤ 5. Conclusion: In the present study, Total airway score of the airway assessment factor was more than 6 points or if the ULBT was class III, the prediction of difcult endotracheal intubation was possible. The Wilson score and the LEMON method are commonly used among all the different airway predictors.