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Rivista di Anestesia, Rianimazione, Terapia Antalgica e Terapia Intensiva

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2018 March;84(3):337-45

DOI: 10.23736/S0375-9393.17.12144-9


lingua: Inglese

Role of flexible fiberoptic laryngoscopy in predicting difficult intubation

Ying GUO 1, Yufang FENG 2, Hui LIANG 3, Rubo ZHANG 4, Xiaolan CAI 1, Xinliang PAN 1

1 Department of Otorhinolaryngology, Qilu Hospital, Shandong University, Jinan, China; 2 Department of Otorhinolaryngology, Weifang Yidu Central Hospital, Weifang, China; 3 Department of Otorhinolaryngology, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China; 4 Department of Otorhinolaryngology, Xiajin People’s Hospital, Dezhou, China


BACKGROUND: The ability to precisely predict which intubations will be difficult during administration of anesthesia is an important part of preoperative preparation. This study’s goal is to accurately identify patients who will be difficult to intubate using the number of tracheal rings observed preoperatively by fiberoptic laryngoscopy.
METHODS: We enrolled 994 adult patients in our study who required general anesthesia and orotracheal intubation for their elective surgeries. All patients received a Mallampati Test, a Wilson Risk-Sum Score, and fiberoptic laryngoscopy before operation. Each patient’s age, Body Mass Index (BMI), and neck circumference was recorded preoperatively. Logistic regression analysis was applied to evaluate the association between the recorded risk factors and a potentially difficult intubation. The three preoperative assessments were compared using three parameters: positive predictive value, sensitivity, and specificity.
RESULTS: The risk factors which were determined to be predictive for difficult intubation were: BMI, neck circumference, Mallampati Test, Wilson Risk-Sum Score, and fiberoptic laryngoscopy (P<0.05). Fiberoptic laryngoscopy as a predictive factor in the preoperative setting had a higher sensitivity, specificity, and positive predictive value than did the Mallampati Test or the Wilson Risk-Sum Score (P<0.05).
CONCLUSIONS: Fiberoptic laryngoscopy is a more accurate and convenient preoperative method to predict difficult intubation.

KEY WORDS: Laryngoscopy - Intubation - Endoscopes

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Publication History

Issue published online: April 3, 2018
Article first published online: October 4, 2017
Manuscript accepted: September 26, 2017
Manuscript revised: September 6, 2017
Manuscript received: April 19, 2017

Per citare questo articolo

Guo Y, Feng Y, Liang H, Zhang R, Cai X, Pan X. Role of flexible fiberoptic laryngoscopy in predicting difficult intubation. Minerva Anestesiol 2018;84:337-45. DOI: 10.23736/S0375-9393.17.12144-9

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