Title: Proportion of Poor Visualisation of Glottis Documented Using Cormack-Lehane Grading During Anaesthesia

Authors: V R Bindhumol, Rehana B, Linette. J. Morris

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i6.198

Abstract

Despite detailed clinical evaluation of the airway, unanticipated intubation difficulty is encountered in a small subset of patient population. An attempt is made to study the proportion of people in our setting who have Cormack-Lehane Grade 3 & 4 who were previously assessed to have normal airway by classical methods; and also the intubation difficulties which were encountered during anaesthesia. 213 patients who had consented and were assessed to have normal airway were anaesthetised for elective surgery and during laryngoscopy, the Cormack-Lehane Grade and the ease of intubation according to intubation difficulty scale were noted. In this study involving 213 patients, 18 patients were having Cormack-Lehane Grade3 view (8.5%). Of the total 18 patients, 17 patients met with intubation difficulty with a score of more than 5 (8%).It was found that Cormack-Lehane grading is a significant predictor of difficult intubation. It was also found that the sensitivity of Modified Mallampati Classification (MMC) in predicting Grade 3 Cormack-Lehane was 61.1and the specificity was 45.6. It is less reliable as a single predictor of difficult intubation. Likewise the Wilson Risk Sum Score is very sensitive in predicting difficult laryngoscopy, but it is less specific. It was also found that there is a strong association between Cormack-Lehane Grading and intubation difficulty.

Keywords: Mallampati Classification, Wilsons` Risk Sum Score, Cormack-Lehane Grading, Intubation Difficulty Scale.

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Corresponding Author

Rehana B

Assistant Professor, Department of Anaesthesia,

Government Medical College, Thiruvananthapuram, Kerala, India

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