• Tatjana Goranović, Morena Milić, Nesek AdamVišnjaVDepartment of Anesthesiology, Resuscitation and Intensive Care Medicine, Sveti Duh University Hospital, Zagreb, Croatia.Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.Emergency Department, Sveti Duh Uni, and Boris Šimunjak.
• Department of Anesthesiology, Resuscitation and Intensive Care Medicine, Sveti Duh University Hospital, Zagreb, Croatia.
• Acta Clin Croat. 2023 Apr 1; 62 (Suppl1): 212821-28.

AbstractThe aim of this study was to explore standard anthropometric airway characteristics of patients with obstructive sleep apnea syndrome (OSAS) and determine the incidence and risk factors for difficult airway management. Final analysis included 91 patients with polysomnography-verified diagnosis of OSAS who underwent sleep breathing disorder surgery under general anesthesia with direct laryngoscopy oroendotracheal intubation. The incidence of difficult manual mask ventilation during anesthesia induction, difficult intubation and immediate postextubation respiratory complications was 17.6%, 7.7% and 7.7%, respectively. Compared to patients without difficult manual mask ventilation, the group of OSAS patients with difficult manual mask ventilation had a higher rate of body mass index (BMI) ≥25 kgm-2 (p=0.010), Mallampati score ≥3 (p=0.024) and Cormack-Lehane score ≥3 (p=0.002). The OSAS patients with difficult intubation had more Cormack-Lehane score ≥3 (p=0.002) in comparison to those without difficult intubation. Our study demonstrated that manual mask ventilation during anesthesia induction was the most troublesome airway management task in OSAS patients during sleep breathing disorder surgery. Cormack-Lehane score was a relevant determinator of difficult mask ventilation and difficult intubation, while Mallampati score and BMI were relevant determinators only for difficult manual mask ventilation.Sestre Milosrdnice University Hospital.

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