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Paper Information

Journal:   JOURNAL OF IRANIAN SOCIETY ANAESTHESIOLOGY AND INTENSIVE CARE   2007 , Volume 29 , Number 57; Page(s) 10 To 16.
 
Paper: 

THE IMPACT OF FORWARD MOVEMENT OF THE LOWER MANDIBLE IN PREDICTING DIFFICULTY IN INTUBATION

 
 
Author(s):  HOSSEINKHAN ZAHED, MIR AZIMI F.
 
* 
 
Abstract: 

Background: Failed endotracheal intubation is one of the principal causes of morbidity and mortality in anesthetized patients. The aim of this study was to investigate the efficiency of forward movement of the mandible in predicting difficult intubation.
Materials and methods: In a prospective study, 300 patients (aged more than 16 yr), scheduled for elective surgery were enrolled. Forward movement of the mandible was measured in each of the patients before operation by a single anesthesiologist. It was defined as the difference between the distances of lower and upper incisores in neutral and during maximum mandibular protrusion in millimeter. At the time of intubation, another anesthesiologist blinded to the preoperative airway assessment test performed a laryngoscopy and determined the laryngoscopic view according to the Cormack and Lehane scoring system. Difficult intubation was defined as laryngoscopic views of grade III and IV.
Results: Twenty one patients were identified as having difficult intubation. The forward movement of the mandible as significantly more in patients with easy intubation compared to those with difficult intubation (6.42
±1.95 mm vs. 3.58±1.26 mm respectively, p<0.001). Using the cutoff point of 5 mm or less for prediction of difficult intubation was accompanied with  the sensitivity of 92.86% and the specificity of 70.43%.
Conclusion: The forward movement of the mandible is significantly more in patients with easy intubation compared to difficult intubation.

 
Keyword(s): DIFFICULT INTUBATION, FORWARD MOVEMENT OF THE MANDIBLE, AIRWAY PREDICTION
 
References: 
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