Ultrasonographic measurement of three domain of airway to predict difficult laryngoscopy
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 149
- Locations
- 1
- Primary Endpoint
- Ultrasonographic measurement of paramteres of airway will be helpful in identifying difficult airway
Study Overview
Brief Summary
Aim of the study is to predict difficult laryngoscopy with ultrasonography using the measurement of three domains in airway-Oral space domain (tongue thickness),Anterior neck soft tissue thickness domain (ANS-VC) and anatomic position domain (HMDR)Inspite of multiple clinical parameters for assessment of difficult airway,incidence of unanticipated difficult laryngoscopy is (1-8%).Clinical assessment can not be done in uncooperative and unconscious patients.Hence USG airway is helpful in overcoming the above said troubles.Hence this study will be helpful in identifying difficult airway.
After obtaining clearance from the institutional ethics committee and registering in CTRI,informed consent will be taken from the patient on the day before the surgery.Patient selection will be based on the inclusion and exclusion criteria posted for elective surgery under general anaesthesia.In the preanaesthetic evaluation,airway assessment like Modified Mallampatti Classification,Thyromental distance,Sternomental distance and interincisor gap distance and neck circumference will be measured using a scale in cms.
On the day of the surgery,enrolled patients will undergo USG examination of airway using sonosite in the preoperative room by a skilled investigator.ANS-VC measurement is done by keeping a linear probe (10-13MHz frequency) in transverse plane,with the patient lying in supine position and head kept in neutral position.ANS-VC will be measured from skin to anterior commissure of true VC by keeping the probe at the level of vocal cords,depth measurement is done in the central axis of neck in cm.HMDR mearurement is done using a curvilinear probe(4-10MHz frequency).Probe is kept in sagittal plane in suprahyoid region and HMD is calculated by measuring distance from hyoid bone and mentum in neutral position and extended position.HMDR is calculated by dividing HMD in neutral to HMD in extended position.Tongue thickness is measured by stretching the neck and placing probe under the chin in median sagittal plane using a curvilinear probe.Maximal vertical dimension from tongue to submental skin is measured.After induction of patient using standard method,grades of laryngoscopy is noted and compared that with the ultrasonographic parameters
Study Design
- Study Type
- Observational
Eligibility Criteria
- Ages
- 18.00 Year(s) to 70.00 Year(s) (—)
- Sex
- All
Inclusion Criteria
- •a.Patients scheduled for elective procedures under General anaesthesia.
- •b.Age 18-70years c.American Society of Anaesthesiologists -physical status( ASA-PS) class 1 and 2 patients.
Exclusion Criteria
- •Patients with facial trauma b.
- •Patients with facial tumors c.
- •Patients with cervical trauma d.
- •Patients with upper airway anatomical abnormality e.
- •Patients with history of difficult airway in previous surgery f.
- •Patients who are pregnant.
Outcomes
Primary Outcomes
Ultrasonographic measurement of paramteres of airway will be helpful in identifying difficult airway
Time Frame: in the preoperative period before shifting inside theatre
Secondary Outcomes
- The efficacy of ultrasonography in predicting difficult airway can be compared with clinical parameters to predict difficult airway.(In the preoperative period)
Investigators
DR SUSHMA H
KASTURBA MEDICAL COLLEGE,MANIPAL