Difficult intubation risk assessment in bariatric surgery

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OBJECTIVE

To develop the optimal method for assessing the risks of difficult tracheal intubation in obese patients.

MATERIAL AND METHODS

A prospective study included 116 patients who underwent surgery in 2022. To predict the risk of difficult tracheal intubation, the authors used the original scale of high-risk tracheal intubation (SHORT). Neck circumference was measured in all patients using a standard centimeter tape. The authors measured mouth opening width, maximum range of movements in atlanto-occipital joint using a universal medical goniometer. In addition, all patients were divided by gender. Depending on statistical significance of all parameters, all indicators were assigned points from 0.5 to 1.5. ROC-analysis was performed.

RESULTS

AUC was 0.906±0.045 with 95% CI 0.817—0.994. This model was significant (p<0.001). Difficult tracheal intubation was predicted by SHORT score ≥2. Sensitivity and specificity of the model were 90.5% and 80.0%, respectively.

CONCLUSION

SHORT has demonstrated diagnostic value in predicting difficult airways in bariatric surgery. According to the authors, this scale can improve the quality of predicting difficult tracheal intubation in obese patients, and, accordingly, improve the quality and safety of anesthetic management.

Keywords:

bariatric surgery

tracheal intubation

risk assessment

prognosis

anesthesiology

Authors:

Maiorov M.O.

Tver State Medical University

ORCID: 0000-0002-4320-4148

Federiakin D.V.

Tver State Medical University

ORCID: 0000-0002-6819-9445

Belevsky E.V.

Tver State Medical University

ORCID: 0000-0002-6411-9161

Silaev V.N.

Tver State Medical University

ORCID: 0000-0002-8627-906X

Tokareva S.I.

Tver State Medical University

ORCID: 0000-0002-0610-6127

Received:

19.04.2024

Accepted:

13.06.2024

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