An Observational Study On The Utility Of Point-Of-Care Ultrasound In Predicting Difficult Airway By Measuring Skin To Epiglottis Distance And Its Association With Cormack-Lehane Grading

The difficult airway is considered as experiencing difficulty with face mask ventilation or difficulty with intubation of upper airway by a trained anesthesiologist. Unpredicted difficult laryngoscopy is a challenge for any anesthesiologist, emergency physicians and intensivists. Although there are various clinical tests for predicting a difficult airway none of them are sensitive enough to detect difficult airway. Cormack-Lehane grading is the closest parameter we have for deciding on the difficulty of endotracheal intubation which can only be known after inducing the patient, providing adequate muscle relaxant and doing direct laryngoscopy. However with the currently existing techniques and tests we can never know the Cormack-Lehane grading beforehand. Hence anesthesiologists were always in search of a tool that wound predict the difficult intubation before inducing the patient. With the advent of ultrasonography in medical field we have an opportunity to explore new techniques which can prove to be more sensitive than the current tests. Point-of-care ultrasound can be a quick, non-invasive bedside technique to assess the difficult airway before inducing patient for general anesthesia. After obtaining due permission from the institutional ethics committee and approval of West Bengal University of Health Sciences we will collect data from at least 249 patients who are posted for elective surgery planned under general anaesthesia with endotracheal intubation. We will also record the time taken from laryngoscopy till cuff inflation of endotracheal tube and number of attempts and find if there is association with ultrasonography findings. After the collection of data from all participants, we will present statistically significant data among the participating patients.