CHANGES IN MALLAMPATI GRADING IN UROLOGICAL PROCEDURES DONE IN LITHOTOMY AND PRONE POSITIONS

Not yet recruiting

Conditions: Calculus of kidney with calculus of ureter,

Registration Number: CTRI/2021/05/033423

Lead Sponsor: NIZAMS INSTITUTE OF MEDICAL SCIENCES

Brief Summary: After ethics approval subjects will be recruited into the study after informed and written consent, prospective observational study will be done in patients undergoing elective PCNL(prone) and URSL, TURBT(lithotomy) surgeries under general anesthesia requiring oral endotracheal tube. Each group has 30 patients each

Preoperative:

Thorough history about patients past and present illness will be taken along with general and systemic examinations being done. Routine investigations will be done. Height, weight and nutritional status of the patient are noted. Airway assessment will be done using mallampati grading with patient in sitting position head neutral mouth open as wide as possible and maximal tongue protrusion without phonation along with other airway parameters like thyromental distance, sternomental distance,inter incisor distance, neck circumferences.

Intraoperative:

Patients will be shifted to the OT after fasting status is confirmed. All the ASA standard monitors connected. IV lines secured. Patient is preoxygenated with 100% oxygen for 3 minutes. Premedicated with glycopyrrolate and Fentanyl 1-2 mcg/kg. Patient induced with propofol 1-2mg/kg and sevoflurane 2%. After the ability to ventilate is confirmed, relaxant atracurium is given 0.5 mg/kg. Bag mask ventilation is done for 3mins. Tracheal intubation is done with appropriate oral endotracheal tube bilateral air entry confirmed and fixed and connected to mechanical ventilation. Number of attempts for intubation, use of bougie(if any) and duration of intubation is noted. Anaesthesia is maintained on sevoflurane 2% ,Oxygen , Air, and intermittent relaxant boluses. Appropriate analgesia is given. Duration of surgery, amount of intraoperative fluids given, amount of irrigating fluids used are noted. Post procedure patients are reversed of neuromuscular blockade with neostigmine 50mcg/kg and glycopyrrolate 10mcg/kg. After assessing the patientâ€™s spontaneous breath attempts and attaining adequate muscle power trachea is extubated.

Postoperative:

Patient is followed up postoperatively at 4hrs, 8hrs, 12hrs,24hrs, 48hrs, 72hrs, intervals and the MPG grade is noted in sitting position without phonation with maximal mouth opening and tongue protrusion with head in neutral position and any changes are noted. If any change is noted the patient is followed up it is reverted back to normal and the duration for it is noted. The study is discontinued after the MPG grade reverts to the preoperative grade. The MPG grade is evaluated by a resident not involved in the study.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 60

Inclusion Criteria

ASA Grade I II Age 18 to 60 MPG grade I II III Any gender Patients undergoing elective urological surgeries URSL TURBT PCNL Patients willing to participate.

Exclusion Criteria

Patient refusal Anticipated difficult airway difficult mask ventilation difficult intubation MPG grade IV Inability to open mouth for assessment.

Study & Design

Study Type: Observational

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
To evaluate the changes in mallampati grading in patients undergoing elective urological procedures in lithotomy URSL TURBT and prone PCNL positions under general anaesthesia	Mallamapti grade is assessed preoperatively and postoperatively at 4hrs, 8hrs, 12hrs, 24hrs, 48hrs, 72hrs, 96hrs and the study is discontinued when mallampati grade reverts to the preoperative state
and the time required to revert to the preoperative state	Mallamapti grade is assessed preoperatively and postoperatively at 4hrs, 8hrs, 12hrs, 24hrs, 48hrs, 72hrs, 96hrs and the study is discontinued when mallampati grade reverts to the preoperative state

Secondary Outcome Measures

Name	Time	Method
To find out any relation b/w the volume of intraoperative i.v fluids and irrigation fluids used and	Duration of surgery for the PCNL,URSL, TURBT surgery for aggravating airway edema

Trial Locations

Locations (1): NIZAMS INSTITUTE OF MEDICAL SCIENCES
🇮🇳
Hyderabad, TELANGANA, India
NIZAMS INSTITUTE OF MEDICAL SCIENCES
🇮🇳Hyderabad, TELANGANA, India
CHAGANTI SHARMILA
Principal investigator
8106177998
sharmila.chaganti@gmail.com