• Rev Bras Anestesiol · Mar 2018

    Observational Study

    [Difficult laryngoscopy and tracheal intubation: observational study].

    • Rebeca Gonelli Albanez da Cunha Andrade, Bruno Luís Soares Lima, Douglas Kaíque de Oliveira Lopes, Roberto Oliveira Couceiro Filho, Luciana Cavalcanti Lima, and Couceiro Tania Cursino de Menezes TCM Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Anestesiologia, Recife, PE, Brasil; Universidade Federal de Perna.
    • Instituto de Medicina Integral Professor Fernando Figueira (IMIP), Anestesiologia, Recife, PE, Brasil. Electronic address: bekinhagonelli@hotmail.com.
    • Rev Bras Anestesiol. 2018 Mar 1; 68 (2): 168-173.

    IntroductionSince anesthesia complications associated with unexpected difficult airway are potentially catastrophic, they should be avoided. The modified Mallampati test and jaw-thrust maneuver enable the identification of difficult airway. The aim of this study was to associate the modified Mallampati test and the jaw-thrust maneuver with laryngoscopy (Cormack-Lehane) in an attempt to identify a better predictor of difficult airway in an adult population undergoing elective surgery.MethodA cross-sectional study in which 133 adult patients undergoing elective surgery requiring tracheal intubation were analyzed. The accuracy and specificity of the modified Mallampati test and jaw-thrust maneuver were assessed by correlating them with difficult laryngoscopy (Cormack-Lehane Degrees 3 and 4).ResultsIn the 133 patients evaluated the difficult intubation rate found was 0.8%; there was association between the two predictive tests proposed (p=0.012). The values of 94.5% for specificity and 95.4% for accuracy were found for the jaw-thrust maneuver and for the modified Mallampati test, the values found were 81.1% and 81.2%, respectively. Kappa agreement identified a result of 0.240 between jaw-thrust maneuver and Cormarck-Lehane, which was considered reasonable. On the other hand, a poor agreement (κ=0.06) was seen between modified Mallampati test and Cormarck-Lehane test.ConclusionThe jaw-thrust maneuver presented superior accuracy and agreement than the modified Mallampati test, showing the ability to identify a difficult airway. It is necessary to emphasize the association of tests in the evaluation of patients, emphasizing their complementarity to minimize the negative consequences of repeated laryngoscopies.Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

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