Prediction of ease of laryngoscopy and intubation-role of upper lip bite test, modified mallampati classification, and XXXX in various combination.

@entity1 @entity5529
BACKGROUND: The incidence of difficult intubation in @entity1 undergoing general anaesthesia is estimated to be approximately 1-18% whereas that of failure to intubate is 0.05-0.35%.1,2,3 Various methods have been used for prediction of difficult laryngoscopy. Although, upper lip bite has been shown to be a promising test in its introductory article, repeated validation in various populations is required for any test to be accepted as a routine test. We have compared upper lip bite test (ULBT), modified Mallampati test (MMC) and @entity5529 ( @entity5529 ) individually and in various combinations to verify which of these predictor tests are significantly associated with difficult glottic exposure. METHODS: After obtaining institutional ethics committee approval, 402 ASA I and II adult @entity1 undergoing elective surgical procedures requiring endotracheal intubation were included. All the three test were performed in all the @entity1 preoperatively and their glottic exposure was recorded by Cormack-Lehane classification during intubation. Sensitivity, specificity, positive predictive value and negative predictive value were used for comparison. RESULTS: In our study, the incidence of difficult laryngoscopy was 11.4% and failure to intubate 0.49%. None of the three are a suitable predictive test when used alone. Combination of tests added incremental diagnostic value. CONCLUSION: We conclude that all three screening tests for difficult intubation have only poor to moderate discriminative power when used alone. Combinations of individual tests add some incremental diagnostic value.
