Year : 2019 | Volume
: 8 | Issue : 1 | Page : 11--15
Comparison of upper-lip bite test with other four predictors for predicting difficulty in intubation
N Hemanth, T Rajasekhar, Swami Devi Prasad Ilapanda, Prabhu Gnapika Putta, Pabba Shravani, Dyva Manogna, MH Rao
Department of Anesthesiology and Critical Care Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
Background: Unanticipated difficult tracheal intubation remains a primary concern of anaesthesiologists. The aim of the present study was to compare upper-lip bite test (ULBT) with other four predictors namely modified Mallampati test (MMT), thyromental distance (TMD), sternomental distance (SMD) and interincisor distance (IID) for predicting difficulty in intubation.
Methods: Airway assessment indices were evaluated and compared in 60 American Society of Anesthesiologists physical status Grade I and II patients undergoing general anaesthesia at a tertiary care teaching hospital in South India. The cut-off points for defining the difficult intubation (DI) were as follows: for ULBT, Class III; MMT, Classes 3 and 4; TMD <6 cm; SMD <11 cm and IID <3.5 cm. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each of the predictive tests.
Results: DI was observed in 26.7% of all patients studied. Sensitivity, specificity, PPV, NPV and accuracy for ULBT were 6.3%, 97.7%, 50%, 74.1% and 73.3%, respectively, whereas those for MMT were 25%, 86.4%, 40%, 76% and 70%, respectively. MMT showed 50% sensitivity and 84.5% specificity in assessing difficulty in intubation when compared with ULBT, whereas all the other methods have shown 0% sensitivity. MMT is a better predictor of difficulty in intubation when compared with ULBT due to its high sensitivity, better specificity, PPV and accuracy.
Conclusions: No single airway predictor was accurate in predicting DI. A combination of at least two or more airway predictors has to be analysed to arrive at a near-ideal difficult airway prediction.
Associate Professor, Department of Anesthesiology and Critical Care Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh
|How to cite this article:|
Hemanth N, Rajasekhar T, Prasad Ilapanda SD, Putta PG, Shravani P, Manogna D, Rao M H. Comparison of upper-lip bite test with other four predictors for predicting difficulty in intubation.J Clin Sci Res 2019;8:11-15
|How to cite this URL:|
Hemanth N, Rajasekhar T, Prasad Ilapanda SD, Putta PG, Shravani P, Manogna D, Rao M H. Comparison of upper-lip bite test with other four predictors for predicting difficulty in intubation. J Clin Sci Res [serial online] 2019 [cited 2019 Dec 5 ];8:11-15
Available from: http://www.jcsr.co.in/article.asp?issn=2277-5706;year=2019;volume=8;issue=1;spage=11;epage=15;aulast=Hemanth;type=0