COMPARISON OF TOTAL AIRWAY SCORES AND INTUBATION DIFFICULTY SCORES IN DENTAL PROCEDURES PERFORMED UNDER GENERAL ANESTHESIA: A RETROSPECTIVE STUDY

Year 2023, , 1 - 7, 25.12.2023

Hatice Akpınar , Müge Çına , Berfin Öykü Erdoğan

https://doi.org/10.34108/eujhs.1292148

Abstract

The Total Airway Score, determined by eight bedside tests during the preoperative period, and the Intubation Difficulty Scale, assigned during intubation, are both used to describe and predict difficult intubation. The aim of this study is to investigate the correlation between the Total Airway Score and the Intubation Difficulty Scale.Two hundred,American Society of Anesthesiologists ASA 1-3 patients elective dental treatment, maxillofacial surgery under general anesthesia were included in the study. Airway evaluation was performed preoperatively by total airway score which were; Mallampati classification, thyromental and sternomental distance measurement, head and neck mobility,body mass index (BMI), presence of buck teeth, inter incisors gap, upper lip bite test. After endotracheal intubation, the patients were divided into two groups as a healthy group (intubation difficulty scale (IDS)<4) and difficult intubation (IDS ≥4) according to their estimated difficult intubation scores with seven variables and compared with patients with total airway score > 3 in two groups. In this study, total airway score (> 3), thyromental distance (<6cm), upper lip bite test (class III), mallampati classification (≥ class III), inter incisors gap (<3 cm) and buck teeth (> 0.5) respectively 49.45 (95% CI = 4.75-515.45, P <0.05) 7.72 (95% CI = 1.81-32.9, P <0.05), 21.12 (95% CI = 2.31-192.27, P <0.05), 1.92 (CI 95% = 0.51-7.22), 3.54 (95% CI-) 2.31 (95% CI = 0.49-10.78) was detected.It is concluded that total airway score (> 3), upper lip bite test (class III),thyromental distance measurement (<6 cm), which we use in predicting difficult intubation are the most useful preoperative evaluation factors.

Keywords

Dental care, general anesthesia, intubation.

GENEL ANESTEZİ ALTINDA YAPILAN DENTAL İŞLEMLERDE; ENTÜBASYON ZORLUK SKORU İLE TOPLAM HAVAYOLU SKORUNUN KARŞILAŞTIRILMASI: RETROSPEKTİF ÇALIŞMA

Abstract

Toplam hava yolu skoru, preoperatif muayene sırasında 8 yatak başı testi ile belirlendi. Entübasyon sırasında, Entübasyon Zorluk Ölçeği ile zor entübasyon puanı belirlendi. Her iki değer birbiri ile karşılaştırıldı. Bu çalışma toplam hava yolu skoru ile zor entübasyon uyumuna bakmak amacıyla yapıldı.Çalışmaya genel anestezi altında elektif diş tedavisi, maksillofasiyal cerrahi olan 200Amerikan Anestezistler Derneği(ASA) 1-3 hasta dahil edildi. Hava yolu değerlendirmesi ameliyat öncesi toplam hava yolu skoru; Mallampati sınıflaması, tiromental ve sternomental mesafe ölçümü, baş ve boyun mobilitesi, vücut kitle indeksi (VKİ), tavşan dişlerin varlığı, kesici dişler arası boşluk, üst dudak ısırma testleri ile belirlendi. Endotrakeal entübasyon sonrası hastalar yedi değişkenli tahmini zor entübasyon skorlarına göre sağlıklı grup (entübasyon zorluk skoru (IDS)<4) ve zor entübasyon (IDS ≥4) olmak üzere iki gruba ayrıldı ve her iki grup toplam hava yolu skoru > 3 olan hastalarla karşılaştırıldı. Bu çalışmada toplam hava yolu skoru (> 3), tiromental mesafe (<6cm), üst dudak ısırma testi (sınıf III), mallampati sınıflaması (≥ sınıf III), kesici dişler aralığı (<3 cm) ve tavşan dişlerin öne protrüzyonu ( > 0.5cm) olması zor entübasyon lehine değerlendirildi. İstatistiksel olarak sırasıyla 49.45 (%95 GA = 4.75-515.45, P <0.05) 7.72 (%95 CI = 1.81-32.9, P <0.05), 21.12 (%95 CI = 2.31-192.27, P <0.05), 1.92 ( CI %95 = 0.51-7.22), 3.54 (%95 CI-) 2.31 (%95 CI = 0.49-10.78) saptandı.Zor entübasyonu öngörmede kullandığımız total hava yolu skoru (> 3), üst dudak ısırma testi (sınıf III), tiromental mesafe ölçümünün (<6 cm) en yararlı preoperatif değerlendirme faktörleri olduğu sonucuna varıldı.

Keywords

Diş bakımı, genel anestezi, entübasyon.

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