Evaluation of Acromio-Axillary-Suprasternal Notch Index in Predicting Difficulty in Visualization of Larynxs in Adult Patients

ABSTRACT

In medical specialty, expertise in airway management is essential. Maintaining the airway and providing oxygenation is the responsibility of the anaesthesiologist. He is also responsible for reducing the morbidity, and mortality related to difficult intubation. To reduce the risk associated with difficult visualization of larynx, preoperative assessment of airway is required. To protect patient’s airway, endotracheal intubation is the gold standard. Direct laryngoscopy easily enables the securing the airway. This study was for predictive validity of the current system called acromio-axillo-suprasternal notch index in the assessment of difficult airway management. METHODSA total of 60 adult patients, of either gender, aged 18 - 65 years, of ASA class 1 and 2, undergoing elective surgery under general anaesthesia requiring tracheal intubation participated in this prospective, comparative, observational study. AASI was used for preoperative assessment of airway. Sensitivity, and specificity were calculated for AASI. In this study, data analysis was done using chi- square. p < 0.05 was considered statistically significant. RESULTSDifficult Visualization of Larynx was observed in 3.6 % [95 % confidence interval (1.9 – 5.4 %)] patients. Our study found that sensitivity and specificity were 75 % and 95.7 % respectively. CONCLUSIONSAcromio-Axillary-Suprasternal Notch Index (≥ 0.5) is a clear indicator of difficult larynx visualization with direct laryngoscopy.