PREDICTIBILITY OF ROUTINE PREOPERATIVE AIRWAY ASSESSMENT PREDICTORS FOR PERFORMING INTUBATION IN OBESE PATIENTS: A PROSPECTIVE OBSERVATIONAL STUDY

*Dr. Abhinav Saraf and Dr. Abhijeet Yadav

ABSTRACT

Obesity and its associated health concern represents major causes of morbidity and mortality and have enormous impact on health care spending. Obese patients present special challenge for the anaesthesiologist in airway management. Management of the airway is central to the practice of anaesthesia. Therefore, a study was performed to determine the usefulness of pre-operative assessment of airway in predicting difficult intubation in obese patients. Also to verify the predictability of preoperative airway assessment predictors while performing laryngoscopy in obese patients. So, a prospective observational study was conducted in pre-anaesthetic clinic (PAC) & operation theatre of 350 bedded Superspeciality Hospital, Bhopal Memorial Hospital and Research Centre, Bhopal after obtaining institutional ethics & scientific committee approval. Six variables that may predict difficult intubation were taken. Also each predictor were separately assessed for the predictability of difficult intubation on intubation difficulty scale, and strength of association was found between predictor and IDS score. Statistical analysis was performed using statistical software SPSS Version 20. With the study performed we came to conclude that among the classic risk factors for difficult intubation a Modified Mallampati score of 3 or 4 is a risk factor in obese patients. Mallampati class 3-4 should alert the anaesthesiologist to the possibility of difficult intubation in obese patients. We also found out that Modified Mallampati test, Thyromental distance, Delikan test are the better predictors of difficult intubation

Keywords: Obesity, Intubation difficulty scale (IDS), Modified Mallampati test, Thyromental distance, Delikan test.