An observational study on anthropometric airway parameters as predictive indicators of neonatal difficult airway

To evaluate the accuracy of various anthropometric parameters (age, weight, neck circumference, headcircumference, thyromental distance, sternomental distance, frontal plane to chin distance, and frontal plane to chin distance by weight ratio) in predicting difficult laryngoscopy and intubation among neonates undergoing elective / emergency non cardiac surgery under general anaesthesia requiring endotracheal intubation.

For this a total of 70 neonates (n=70) undergoing elective / emergency non cardiac surgery under general anaesthesia requiring endotracheal intubation satisfying inclusion criteria were selected. Informed and written consent from parents of neonates was taken. PAC, NBM status checked, and patient was shifted to OT . Age, weight, anthropometeric parameters assessed before induction (Head circumference , Neck circumference,  Thyromental distance , Sternomental distance , Frontal plane to chin distance) and readings were kept in sequentially numbered opaque envelopes. Routine monitors will be attached, baseline parameters (BP, PR, SPO2) will be recorded, intravenous fluid will be started through already secured cannula as per hospital protocol. Patients will be premedicated with Inj. Glycopyrrolate 0.005mg/kg, Inj. Fentanyl 1mcg/ kg. Induction will be done with Inj. Thiopentone 5 mg/kg. Inj. Succinylcholine 1.5 mg/kg. Mask  ventilation  will  be  performed, Larngoscopy  will  be  done  by Miller blade size 0 by a anaesthetist blinded to previously recorded readings. CL grading, IDS score will be noted and kept in another set of sequentially numbered opaque envelopes. Anaesthesia will be maintained with O2 + Air (50:50) + Sevoflurane (MAC 1-2) + relaxant Inj. Atracurium 0.5 mg/kg loading dose and 0.1 mg/kg maintenance dose sos.  Intraoperative analgesia was maintained using inj. fentanyl citrate 2 mcg/kg. IPPV will be performed, on completin of surgery reversal agent (inj. Neostigmine 0.07mg/kg+ inj. Glycopyrrolate 0.001mg/kg) will begiven and patient will be extubated after satisfying extubation criteria and pt.will be shifted to recovery room.