Validity Of Ultrasound As Regards Correlation To Cormack-Lehane Grading In Obese Patients
- Conditions
- Difficult Airway Intubation
- Interventions
- Device: Assessing validity of ultrasound as regards correlation to Cormack-Lehane grading in obese patients
- Registration Number
- NCT04205331
- Lead Sponsor
- Zagazig University
- Brief Summary
Since the introduction of real-time ultrasound (US) capabilities, ultrasound technology has been adopted and incorporated into daily practice by many medical and surgical specialties. Using US to help assess the difficult airway constitutes just yet another valuable application of this versatile technology . Since many anesthesia providers had already acquired proficiency in US techniques in US guided vascular access and regional nerve blocks, using US to evaluate the airway could be learned and mastered without too much difficulty. Ultrasound of the upper airway may prove to become a useful adjunct to conventional clinical assessment tools, as it has been successful in visualizing the relevant anatomy and critical structures of the airway..
- Detailed Description
The study is cross sectional observational study in which obese patients will be assessed using conventional clinical methods of airway assessment and by using US for the same patient before induction of anesthesia then correlated to the Cormack-Lehane finding after induction of anesthesia..
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 78
- Age of the patient : (21-60) years old.
- Sex : male & female.
- Physical Status : The American Society of Anesthesiologists (ASA) II-III patients.
- Body mass index : 30 to more than 30 kg / m² .
- Operations: Laparoscopic surgeries,bariatric surgeries and any operation that requires general anesthesia with endotracheal tube placement .
Patient refusal.
- Deformity of the airway anatomy [by masses or tumors].
- Patients with thyroid swellings 'Goitre'.
- Pathology of the airway [edema,burn and arthritis].
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description obese patients Assessing validity of ultrasound as regards correlation to Cormack-Lehane grading in obese patients compare between ultrasonography and conventional clinical methods of airway assessment prior to induction of anesthesia correlating it to the Cormack-Lehane scoring system after induction of anesthesia in obese patients
- Primary Outcome Measures
Name Time Method The ratio of the depth of the pre-epiglottic space (Pre-E) to the distance from the epiglottis to the mid-point of the distance between the vocal cords (E-VC). through study completion, an average of 1 year If It is \[0-1\] ,this suspects Cormack-Lehane Grade 1.If it is \[1-2\],this suspects Cormack-Lehane Grade 2.If it is \[2-3\],this suspects Cormack-Lehane Grade 3
The anterior neck soft tissue thickness at the level of the vocal cords (ANS-VC) through study completion, an average of 1 year ANS-VC \>0.23 cm had a sensitivity of 85.7% in predicting a Cormack-Lehan Grade 3 or 4
- Secondary Outcome Measures
Name Time Method Modified Mallampati classification through study completion, an average of 1 year Class I is visualization of the hard palate, soft palate, fauces, uvula, and pillars.
Class II is visualization of the hard palate, soft palate, fauces, and base of uvula.
Class III is visualization of the hard palate and soft palate. Class IV is visualization of only the hard palateInterincisor gap through study completion, an average of 1 year If it is less than 5 cm (approximately three finger breadths) with limited forward protrusion of the mandible ,this is associated with increased risk of difficult laryngoscopy
Thyromental distance through study completion, an average of 1 year If \< 6cm ,this predicts difficult laryngoscopy
The anterior neck soft tissue thickness at the level of the hyoid bone (ANS-Hyoid) through study completion, an average of 1 year If it is 1.69 cm \[1.19 cm to 2.19 cm\],this suspects difficult laryngoscopy.If it is 1.37cm \[1.27 cm to 1.46 cm\], this suspects easy laryngoscopy
Tongue volume will be derived from multiplication of the midsagittal cross-sectional area of the tongue by its width obtained from transverse sonograms through study completion, an average of 1 year Large tongue volume suspects difficult laryngoscopy
The hyomental distance of the patient in neutral position of the neck and in fully extended neck calculating the ratio between both of them through study completion, an average of 1 year If The mean hyomental distance ratios is (1.02 ± 0.01) ,this suspects difficult intubation.If it is (1.14 ± 0.02) ,this suspects easy intubation
Sternomental distance through study completion, an average of 1 year If \< 12.5 cm ,this predicts difficult laryngoscopy
Neck Extension and Flexion through study completion, an average of 1 year inability to extend or flex the neck suspects difficult laryngoscopy
Trial Locations
- Locations (1)
Zagazig University
🇪🇬Zagazig, Egypt