Comparison of newer airway assessement tests- upper lip bite test (ULBT), ratio of height to thyromental distance (RHTMD), thyromental height test (TMHT), and acromio-axillo suprasternal notch index(AASI) for visualization of larynx in geriatric population: A prospective, observational study

This study will be a prospective, comparative, double blinded, observational study. Patients will be included, age more then 60 years, of either sex, BMI  < 30 kg/m2, ASA physical status I and II and schedule for elective surgery under general anaesthesia requiring endotracheal intubation. Aim is comparison of newer airway assessment tests include acromio-axillo suprasternal notch index (AASI), upper lip bite test (ULBT), ratio of height to thyromental distance (RHTMD), thyromental height test (TMHT) and for prediction of difficult visualization of larynx (DVL) in geriatric population.

Primary objective is to evaluate the efficacy of AASI (sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy) for prediction of DVL preoperative and secondary objective isto compare AASI with other bedside tests such as ULBT, RHTMD and TMHT for prediction of DVL and correlation of above assessment tools with modified Cormack - Lehane grading (MCLG) for glottic visualization.

All the patients will be subjected to detailed history, complete physical as well as systemic examination before surgery in preoperative checkup. Patient’s required parameters, routine and all relevant investigations will be checked. The purpose and protocol of the study will be explained to the patients and informed written consent will be obtained.

In the operating room  a standardized anesthesia technique will be followed to give anaesthesia to patient. Laryngoscopy will be performed and the laryngoscopic view will be graded using MCLG grading. All the parameter will be recorded and documented and analyzed using standard qualitative and quantitative test.