Estimate of the Degree of Difficulty in Endotracheal Intubation in Patients with Obstructive Sleep Apnea Syndrome. |
Chang Jae Kim, Jun Seuk Chea, Mee Young Chung, Jang Hyuk Mun, Byung Ho Lee |
Department of Anesthesiology, College of Medicine, The Catholic University of Korea, Seoul, Korea. |
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Abstract |
BACKGROUND Tracheal intubation may be difficult in many patients with sleep apnea syndrome because of anatomical abnormalities in their upper airway. METHODS For 30 patients with obstructive sleep apnea syndrome, we evaluated two classifications; Samsoon-Young and Cormack-Lehane, and five airway examinations; interincisors' distance on mouth opening (DI), angle on cervico-occipital extension (ACO), thyromental distance (TD), and existence of edentulous with atrophic mandible and prominent maxillary incisor. RESULTS 20 patients (67%) belonged to class III or IV according to the Samsoon-Young classification and 22 patients (73%) to grade III or IV according to the Cormack-Lehane classification. The incidence rate for DI less than 40 mm, ACO less than 160o, TD less than 60 mm, atrophic mandible and prominent maxillary incisor were 30%, 37%, 50%, 13% and 27% respectively. CONCLUSIONS According to our results, we concluded that most patients with obstructive sleep apnea syndrome are difficult for anesthesiologists to intubate. Therefore, we suggest that anesthesiologists must prepare variable methods for ventilation if there is any suspicion of difficult intubation in those patients. |
Key Words:
Airway; obstructive sleep apnea syndrome; difficulty; grade |
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