Vikram Bedi, Sandeep Kumar, Sandeep Sharma, Monika Gupta, Dr. Jyoti Gaikwad
Background: This study evaluated impact of Anaesthesiologist’s Experience on prediction of difficult airway using standard assessment tools. Methods: 700 patients scheduled to undergo surgery under General Endotracheal Anaesthesia (GETA) were included in the study. Patients were randomly divided into two groups. In group I airway assessment was done by resident anaesthesiologists (with at least 2 years of experience) and in group II airway assessment was done by a consultant anaesthesiologist (> 5 years of experience) using Mallampati scoring system and LEMON scoring system. Airway was graded as difficult or not difficult. The actual presence/ absence of a difficult endotracheal intubation were reported by a consultant anaesthesiologist unaware of the prediction. These findings were compared to the pre anaesthetic evaluation finding to determine correct/incorrect prediction of difficult airway. Sensitivity, specificity, positive predictive value, negative predictive value and Youden index were determined for all tests. Results: Difficult tracheal intubation occurred in 3% (21 patients) case and no failed intubation occurred. Group I had Sensitivity 55.56%,specificity 97.95%, PPV64.29%, YOUDEN index 0.54, ODD’S ratio 59.64 % while Group 2 had sensitivity of 64.29%,specificity of 98.51%, PPV 64.29% YOUDEN INDEX 0.63, ODD’S ratio 119.16. Conclusions: The present study suggests that increased experience of the evaluating Anaesthesiologists enhances the accuracy of Mallampati test for predicting difficult intubation with higher sensitivity, PPV and YOUDENS index when compared to evaluation done by inexperienced Anaesthesiologists.
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