FREQUENCY OF DIFFICULT AND FAILED INTUBATION IN APPARENTLY NORMAL PATIENTS UNDERGOING ELECTIVE SURGERY

Difficult and Failed Intubation in Elective Surgery

Abstract

Objective: To find the frequency of difficult and failed intubation in apparently normal patients undergoing elective surgery. We also aimed to look at sensitivity and specificity of Mallampatti classification in our population.

Study Design: Cross sectional study.

Place and Duration of Study: Combined Military Hospital, Rawalpindi and Multan from 1^st May 2013 to 1^st June 2013.

Patients and Methods: There were 467 patients, who underwent elective surgery with general anesthesia and endotracheal intubation. During their pre-anesthetic visit, we assessed the airway according to Mallampatti score. After endotracheal intubations, frequency of difficult intubations was evaluated (i.e. Grade III and Grade IV) with special emphasis on intubation done by consultant anaesthetist and post graduate trainees followed by frequency of failure of intubation and other complications during intubation were also noted. Furthermore, comparison of Mallampatti with Cormack & Lehane’s classification of difficult intubation was done.

Results: Difficult intubation in these centers was 4.28% (20/467). Sensitivity of mallampatti was 98.2%. Incidence of failure of intubation was 0.42% in our study.

Conclusion: The frequency of difficult intubation is 4.28% whereas failure of intubation is very low (0.42%) and was observed in special cases only. In our study, the sensitivity of Mallampatti to Cormack & Lehane’s classification of intubation was 98.2% which suggests that it is a sensitive predictor of difficult intubation but complete accuracy cannot be determined by using the Mallampatti score.