Background: Recently, various methods are used to determine the difficult laryngoscopy. In this study, we tried to compare the acromioaxillosuprasternal notch index (AASI) function with old head and neck anatomic criteria in predicting difficult laryngoscopy in trachea intubation under general anesthesia in children.
Methods: in this cross-sectional study, 379 children under intubation with general anesthesia entered the study. Patients were divided into two groups of easy laryngoscopy (grade 1 and 2) and difficult laryngoscopy (grade 3 and 4) based on Cormack-Lehane score. Thyromental distance systems, height to thyromental distance, ULBT test, neck circumference and AASI were studied and compared.
Results: laryngoscopy was difficult in 48 subjects (38 grade 3 and 10 grade 4). There was no significant difference between easy and difficult laryngoscopies based on the thyromental distance, neck circumference, height to thyromnetal distance and AASI (P>0.05). Height to thyromental distance, AASI, and neck circumference have sensitivity of 32.2%, 47.9%, 51.1%, respectively and the specificities were 52.7%, 45.6%, and 48.9%, respectively.
Conclusion: neck circumference and ASSI outperform the height to thyromental method. On the other hand, MMT is better than ULBT in determining difficult laryngoscopy in children.
2. Ghignone M, Quintin L, Duke P, Kehler C, Calvillo O. Effects of clonidine on narcotic requirements and hemodynamic response during induction of fentanyl anesthesia and endotracheal intubation. Anesthesiology. 1986;64(1):36-42.
3. Langeron O, Masso E, Huraux C, Guggiari M, Bianchi A, Coriat P, et al. Prediction of difficult mask ventilation. Anesthesiology: The Journal of the American Society of Anesthesiologists. 2000;92(5):1229-36.
4. Oates J, Macleod A, Oates P, Pearsall F, Howie J, Murray G. Comparison of two methods for predicting difficult intubation. BJA: British Journal of Anaesthesia. 1991;66(3):305-9.
5. Frerk C. Predicting difficult intubation. Anaesthesia. 1991;46(12):1005-8.
6. SHIGA T. Predicting difficult intubation in apparently normal patients. A meta analysis of bedside screening test performance. Anesthesiology. 2006;105:885-91.
7. Rose DK, Cohen MM. The airway: problems and predictions in 18,500 patients. Canadian Journal of Anaesthesia. 1994;41(5):372-83.
8. Vannucci A, Cavallone LF. Bedside predictors of difficult intubation: a systematic review. 2016.
9. Khan ZH, Mohammadi M, Rasouli MR, Farrokhnia F, Khan RH. The diagnostic value of the upper lip bite test combined with sternomental distance, thyromental distance, and interincisor distance for prediction of easy laryngoscopy and intubation: a prospective study. Anesthesia & Analgesia. 2009;109(3):822-4.
10. Naguib M, Scamman FL, O'sullivan C, Aker J, Ross AF, Kosmach S, et al. Predictive performance of three multivariate difficult tracheal intubation models: a double-blind, case-controlled study. Anesthesia & Analgesia. 2006;102(3):818-24.
11. Honarmand A, Safavi M. Prediction of difficult laryngoscopy in obstetric patients scheduled for Caesarean delivery. European journal of anaesthesiology. 2008;25(9):714-20.
12. Myneni N, O'Leary AM, Sandison M, Roberts K. Evaluation of the upper lip bite test in predicting difficult laryngoscopy. Journal of clinical anesthesia. 2010;22(3):174-8.
13. KAMRANMANASH MR, JAFARI A, GHARAEE B, AGHA MH, POORZAMANI M, KASHI AH. COMPARING THE NEW ACROMIO–AXILLO–SUPRASTERNAL NOTCH INDEX WITH MODIFIED MALLAMPATI TEST IN THE PREDICTION OF DIFFICULT LARYNGEAL EXPOSURE. 2012.
14. Safavi M, Honarmand A, Zare N. A comparison of the ratio of patient's height to thyromental distance with the modified Mallampati and the upper lip bite test in predicting difficult laryngoscopy. Saudi journal of anaesthesia. 2011;5(3):258.
15. Kamranmanesh MR, Jafari AR, Gharaei B, Aghamohammadi H, NK MPZ, Kashi AH. Comparison of acromioaxillosuprasternal notch index (a new test) with modified Mallampati test in predicting difficult visualization of larynx. Acta Anaesthesiologica Taiwanica. 2013;51(4):141-4.
16. Gonzalez H, Minville V, Delanoue K, Mazerolles M, Concina D, Fourcade O. The importance of increased neck circumference to intubation difficulties in obese patients. Anesthesia & Analgesia. 2008;106(4):1132-6.
17. Safavi M, Honarmand A, Hirmanpour A, Jalali H. Acromio-axillo-suprasternal notch index: a new screening test to predict difficult laryngoscopy in general population. Journal of Anesthesia and Surgery. 2016;3(2):0-.
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