A comparative study to predict difficult intubation by using modified mallampati grading in sitting position versus supine position in SMS medical college jaipur

The Mallampati classification  is normally evaluated in the sitting position. However, many patients cannot be evaluated in the sitting position for medical reasons. Thus, we compare the mallampati test in sitting and supine positions in predicting difficult tracheal intubation (DTI). We hypothesize that the diagnostic accuracy of the mallampati test perform in sitting and supine positions would differ

It has been suggested that the size of the base of the tongue is an important  factor determining the degree of difficulty of direct laryngoscopy. A relatively simple grading system which involves preoperative ability to visualize the faucial pillars, soft palate and base of uvula was designed as a means of predicting the degree of difficulty in laryngeal exposure.

Procedure- after evaluating preoperatively, informed and written consent will be taken. Airway examination will be performed by an experienced anaesthesiologist in all cases. The modified Mallampatti score will be measured in a sitting position with the patient’s mouth wide open and protruding tongue without saying "Ah" By observer. Before induction time the same observer demonstrates the modified Mallampati test in supine positionwhile the patient turned to supine in operation theater table. Mallampati classes I and II will considered as easy or low risk and classes III and IV will be considered as difficult or high risk. The anesthetist classifie the laryngoscopy view (Cormack and Lehan’s grade) at the time of induction and intubation using a Macintosh blade 3 or 4. Difficult laryngoscopy will defined as Grade III or IV, whereas an easy laryngoscopy will defined as Grade I or II.