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Clinical Criteria for Airway Assessment: Correlations with Laryngoscopy and Endotracheal Intubation Conditions

Open Journal of Anesthesiology 2013年第7期3卷 320-325页

作者： Gustavo Henrique S. Wanderley Luciana Cavalcanti Lima Tania Cursino de Menezes Couceiro waston vieira silva Raquel Queiroz G. A. Coelho Andrea Cavalcanti C. Lucena Anne Danielle Santos Soares Agreste Regional Hospital Caruaru Brazil Brazilian Society of Anesthesiology Accredited Teaching and Training Center IMIP Recife Brazil. Instituto de Medicina Integral Professor Fernando Figueira (IMIP) Recife Brazil

Difficult intubation, inadequate ventilation and esophageal intubation are the principal causes of death or brain damage related to airway manipulation. The objective of this cross-sectional study was to correlate a preanesthetic evaluation that may be capable of predicting a difficult intubation with the conditions encountered at laryngoscopy and endotracheal intubation. Eighty-one patients submitted to general anesthesia were evaluated at a preanesthetic consultation according to the modified Mallampati classification, the Wilson score and the American Society of Anesthesiologists (ASA) difficult airway algorithm. Findings were then correlated with the Cormack-Lehane classification and with the number of attempts at endotracheal intubation. No statistically significant correlations were found between the patients’ Mallampati classification and their Cormack-Lehane grade or between the Mallampati classification and the number of attempts required to achieve endotracheal intubation. Laryngoscopy proved difficult in four patients and in all of these cases the Wilson score had been indicative of a possibly difficult airway, highlighting its good predicting sensitivity. However, the specificity of this test was low, since another 24 patients had the same Wilson score but were classified as Cormack-Lehane I/II. Moreover, two patients who had a Wilson score ≥ 4 were also classified as Cormack-Lehane grade I/II. The study concluded that the Wilson score, although seldom used in clinical practice, is a highly sensitive predictor of a difficult airway;its specificity, however, is low.

关键词： Preanesthetic Evaluation Respiratory System Airway Endotracheal Intubation Measurement Tech-niques Mallampati Wilson Cormack-Lehane

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