Can Point of care ultrasound predict the difficulty in intubation: A prospective observational study

Unpredictable difficult airway remains a primary concern for anaesthesiologists. Inaccurate assessment may place the patient at risk of hypoxic events  and even death if complications occur and appropriate ventilation cannot be maintained. Therefore accurate airway assessment should be performed for proper

planning and management of unexpected difficult intubations .The incidence of difficult laryngoscopy and tracheal intubation still remains 1.5-13% due to poor reliability of traditional protocols, algorithms and combination of screening tools in identifying a potentially difficult airway.The commonly used screening tests like Modified Mallampatti Classification, interincisor gap, thyromental distance, neck extension, jaw protusion have shown low sensitivity and specificity with limited predictive value.

Ultrasound, due to its portable, non invasive characteristics, is useful bedside tool for airway assessment and is now widely available in operating rooms, emergency departments and criticalcare units. As the role of ultrasound in anaesthesia related airway assessment is encouraging but poorly defined , we have planned to assess its efficacy in predicting unanticipated difficult airway. A scoring system that can reliably assess difficult intubation is Intubation Difficulty Scale, which is done by direct laryngoscopy. However, laryngoscopy being an invasive procedure is difficult to perform in an awake patient, and cannot be used to predict difficult intubation.To our knowledge no study has been done to find the co relation between different preoperative ultrasound parameters and Intubation difficultyscale (IDS), hence the proporsal for this study for consideration.