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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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体重指数与颈围联合应用对围术期困难气道的预测性分析

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中外医疗 2016年第10期35卷 97-98页

作者：荆凤娥秦向阳李秀娜崔修德河南理工大学第一附属医院麻醉科河南焦作454001 河南省焦作市第五人民医院普外科河南焦作454001

目的探讨体重指数与颈围联合应用对围术期困难气道的预测性。方法方便选择2014年3—9月河南理工大学一附院于全麻下气管内插管行择期手术的患者120例,麻醉前分别进行mallampati(M氏)评分和体重指数-颈围评分来预测气管插管的困难程度,... 详细信息

目的探讨体重指数与颈围联合应用对围术期困难气道的预测性。方法方便选择2014年3—9月河南理工大学一附院于全麻下气管内插管行择期手术的患者120例,麻醉前分别进行mallampati(M氏)评分和体重指数-颈围评分来预测气管插管的困难程度,并应用Cormack and Lehane(C-L)喉头分级评分作为标准评价插管的困难程度。计算2种评估方法的敏感性、特异性、阳性预测值、阴性预测值及精确度,并在两者之间进行比较。结果体重指数-颈围评分在预测气管插管困难程度的敏感性为64.7%、特异性81.6%、阳性预测值36.7%、阴性预测值94.4%、精确度79.2%;M氏评分其对应指标分别为58.8%、86.3%、41.7%、92.6%、81.7%。结论体重指数-颈围评分对困难气道有一定预测的价值,值得临床关注。

关键词：体重指数颈围 mallampati C-L喉头分级

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