Incidence and predictors of unanticipated difficult airway in cases of ankylosing spondylitis – a prospective observation single centric study

American society of anesthesiologists defines a difficult airway as the clinical situation in which a

trained anesthesiologist has difficulty with face mask ventilation of the upper airway, difficulty with

tracheal intubation, or both. Ankylosing spondylitis (AS) can present significant challenges to the

anesthetist in view of potentially difficult airway with worsening disease status, namely limitation of

movement at the cervical spine and jaw. Associated systemic factors such as pulmonary and cardiovascular

complications, along with the risk of iatrogenic cervical spine fractures leading to neurological

deterioration adds on to the challenge. However, a careful pre-operative assessment of the overall

functional status of the patient along with a comprehensive airway assessment will allow the

anesthetist to anticipate and circumvent problems faced intra-operatively, thereby reducing overall

morbidity and mortality associated with anesthesia. This study aims to identify systemic and airway

parameters associated with the disease that could serve as predictors of an unanticipated difficult

airway