Journal of Anaesthesiology, Clinical Pharmacology最新文献

{"title":"Perioperative approaches to prevent delayed neurocognitive recovery and postoperative neurocognitive disorder in older surgical patients: A systematic review and meta-analysis of randomized controlled trials.","authors":"Yasmin Alhamdah, Wei-Ya Li, Mahesh Nagappa, Ellene Yan, David He, Aparna Sarieplla, Marina Englesakis, Zeyad Elias, Matthew T V Chan, Dong-Xin Wang, Frances Chung","doi":"10.4103/joacp.joacp_396_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_396_23","url":null,"abstract":"<p><strong>Background and aims: </strong>Delayed neurocognitive recovery (DNR) and postoperative neurocognitive disorder (P-NCD) are common postoperative complications affecting older patients. This review evaluates perioperative approaches for preventing DNR and P-NCD in older noncardiac surgical patients.</p><p><strong>Material and methods: </strong>We searched databases for relevant articles from inception through June 2022 and updated in May 2023 (PROSPERO ID CRD42022359289). Randomized controlled trials (RCTs) utilizing intervention for DNR and/or P-NCD were included.</p><p><strong>Results: </strong>We included 39 RCTs involving anesthetic (25 RCTs, 7422 patients) and other pharmacological and nonpharmacological approaches (14 RCTs, 2210 patients). Seventeen trials investigating four interventions were included in the meta-analysis for DNR. Perioperative dexmedetomidine (relative risk [RR]: 0.59, 95% confidence interval [CI]: 0.35-0.97; <i>P</i> = 0.04) and propofol-based total intravenous anesthesia (TIVA) (RR: 0.81, 95% CI: 0.66-0.98; <i>P</i> = 0.03) significantly decreased the risk of DNR versus control. There was no significant decrease in the risk of DNR with regional anesthesia (RA) versus general anesthesia (GA) (RR: 0.89, 95% CI: 0.63-1.26) or bispectral index (BIS) monitoring (RR: 0.79, 95% CI: 0.60-1.04) versus the control groups. Evidence regarding the effects of interventions on P-NCD is limited. Although all included trials were at low risk of bias, the quality of meta-analysis pooled estimates was low.</p><p><strong>Conclusions: </strong>Our meta-analysis of RCTs showed that dexmedetomidine and TIVA decrease the risk of DNR in older patients undergoing noncardiac surgery by 41% and 20%, respectively, versus control. Further RCTs of adequate power and methodology on the effects of interventions on DNR and P-NCD are warranted.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"3-14"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of dextrose supplementation on intraoperative blood glucose levels in pediatric patients undergoing major surgeries under general anesthesia with caudal analgesia.","authors":"Sruthi C Babu, Dimple E Thomas, Reshmy Thomas, Geethu Sebastian, Lakshmi Kumar","doi":"10.4103/joacp.joacp_441_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_441_23","url":null,"abstract":"<p><strong>Background and aims: </strong>In children undergoing surgery, the stress responses of surgery can result in blood glucose elevation consequent to release of cortisol and catecholamines. The use of a regional block could attenuate the stress responses and lower the blood glucose levels. We compared the blood glucose values at specified time points during surgery with and without additional dextrose to evaluate the need for glucose supplementation as our primary outcome. Intraoperative hemodynamics and the need for any intervention for correction of blood sugars were noted secondarily.</p><p><strong>Material and methods: </strong>Children aged between 6 months and 8 years undergoing elective major surgery were randomized to group D (received 1% dextrose in Ringer's lactate) or group P (received only Ringer's lactate). Blood sugars were measured half hourly for 2 h following intubation, and data was analyzed using Student's t-test and Chi-square test.</p><p><strong>Results: </strong>Demographic variables and the duration of surgery were comparable. The baseline blood glucose value was lower in group D. Analysis of covariates test for a comparison of adjusted mean blood glucose (MBG) showed the values at 30, 60, and 90 min to be comparable. However, toward the end of surgery, the MBG value was significantly higher in group D (<i>P</i> = 0.019). Heart rate and mean arterial pressure were comparable at the same points of measurement.</p><p><strong>Conclusion: </strong>Dextrose supplementation is not needed for children receiving caudal analgesia for major surgeries of 2-3 h duration and may raise blood sugars at the end of surgery.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"79-83"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative dental injury awareness among anesthesiologists.","authors":"Parul Mullick, Ajay Kumar, Smita Prakash, Shruti Jain","doi":"10.4103/joacp.joacp_432_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_432_23","url":null,"abstract":"<p><strong>Background and aims: </strong>Perioperative dental injury is a known yet preventable complication. We assessed the anesthesiologists' awareness of the predisposing factors, preventive measures, and subsequent management of these injuries, should they occur.</p><p><strong>Material and methods: </strong>A prospective cross-sectional survey was conducted on 385 anesthesiologists practicing in Delhi-NCR to assess their awareness on prevention and management of perioperative dental injuries. A questionnaire comprising 35 questions designed to determine preanesthetic practices, knowledge of dental injury predisposing factors, preventive measures, injury management, and documentation was filled and the collected data was analyzed.</p><p><strong>Results: </strong>Dental risk assessment was always or mostly performed by 93% anesthesiologists. Most anesthesiologists (93%) felt it would be more informative and clearer if preexisting dental condition is noted on a dental chart. Dental consultation was always advised by 14% anesthesiologists for patients with loose or diseased tooth. Limited mouth opening (71%), intubation (98%), and use of laryngoscope (96%) were found to be associated with dental injury. For dental injury prevention, 74% anesthesiologists padded teeth with gauze and 51% preferred to use a video laryngoscope. Knowledge regarding handling and management of avulsed tooth was lacking in most anesthesiologists. Postanesthesia dental status was documented always by only 11%. However, 71% always documented dental injury.</p><p><strong>Conclusions: </strong>Using dental chart in preanesthetic evaluation sheet improves documentation. Anesthesiologists need to be sensitized to the benefits of preanesthetic dental consultation for vulnerable teeth. They need awareness about correct handling and need of immediate reimplantation of avulsed tooth and documentation of postanesthesia dental status.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"119-125"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative iatrogenic superior vena cava obstruction after cardiopulmonary bypass diagnosed by combined pulmonary artery catheter and transesophageal echocardiography.","authors":"B Kirti Chandran, Devesh Dutta, Ravindra Saxena, Sunil Dhole","doi":"10.4103/joacp.joacp_470_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_470_23","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"200-201"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of pharmacological therapy on sleep quality in a postoperative setting: A systematic review of randomized controlled trials.","authors":"Jinny Tsang, Jasmine Kang, Nina Butris, Ellene Yan, Tina Shahrokhi, Jennita Ariaratnam, Aparna Saripella, Marina Englesakis, Dong-Xin Wang, David He, Frances Chung","doi":"10.4103/joacp.joacp_428_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_428_23","url":null,"abstract":"<p><strong>Background and aims: </strong>Postoperative sleep disturbances are associated with delayed recovery and increased incidences of complications. This systematic review aims to determine the impact of perioperative pharmacological therapies on postoperative sleep quality in the hospital.</p><p><strong>Material and methods: </strong>We searched MEDLINE, MEDLINE ePubs and In-Process Citations (Daily), Embase Classic + Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and PubMed for randomized controlled trials (RCTs) from inception to May 2022, with continued literature surveillance until August 2023. Studies included consisted of noncardiac surgical patients aged ≥18 years with postoperative sleep in the hospital. The primary outcome was improvement in postoperative sleep outcomes such as sleep quality, duration, efficiency, architecture, and insomnia ratings after pharmacological treatment. Additional outcomes included postoperative pain scores and opioid consumption.</p><p><strong>Results: </strong>The search strategy yielded 21 studies (<i>n</i> = 3276), and 18 reported improved sleep outcomes using eight validated sleep measurement tools. Eight of 10 studies using dexmedetomidine via patient-controlled analgesia or intravenous infusion reported better sleep quality versus controls. Opioids (nalbuphine, tramadol plus sufentanil), nonopioids (zolpidem, midazolam, pregabalin), propofol total intravenous anesthesia (TIVA), <i>S</i>-ketamine, and ropivacaine nerve blocks were superior to controls in enhancing postoperative sleep quality. Eleven studies (52%) which included the combination of dexmedetomidine with opioids reported concurrent improvements in postoperative pain and sleep. Dexmedetomidine also decreased postoperative opioid analgesia consumption.</p><p><strong>Conclusions: </strong>Evidence for the effects of perioperative pharmacological approaches on postoperative sleep are limited. High-quality RCTs of adequate power and methodology on the effects of pharmacology interventions on postoperative sleep are warranted.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"36-47"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation of blood lactate and bicarbonate levels after stored blood transfusion to predict ICU admission in patients undergoing major head and neck surgeries: A prospective observational study.","authors":"N Sonia Dorathy, Yashwant S Payal, Praveen Talawar","doi":"10.4103/joacp.joacp_430_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_430_23","url":null,"abstract":"<p><strong>Background and aims: </strong>Major head neck surgeries are often associated with major blood loss requiring blood transfusion. However, in spite of transfusion, patients usually suffer adverse postoperative outcomes. Biomarkers can help in identifying such events early. This observational study was conducted to compare blood lactate and bicarbonate levels as predictors of adverse postoperative outcomes.</p><p><strong>Materials and methods: </strong>Forty-eight adult American Society of Anesthesiologists Physical Status I-III patients met the inclusion criteria. Intraoperative blood loss was managed with stored blood transfusion as per transfusion trigger. Blood lactate and bicarbonate levels were measured preoperatively (Tbas), at the immediate postoperative period (T0), and at 8 h (T8), 16 h (T16), and 24 h (T24) postoperatively. Outcomes such as need for intensive care unit (ICU) admission, length of ICU stay, intraoperative blood transfusion, re-exploration rate, and mortality were recorded.</p><p><strong>Results: </strong>Blood transfusions and ICU admissions were required in 19 (39.6%) and 24 (50%) patients, respectively. Lactate levels of patients requiring blood transfusion and admission to ICU rose significantly from their baseline (1.30 ± 0.41 mmol/l) to 2.80 ± 1.14 mmol/l at the immediate postoperative period, which fell to 2.06 ± 0.78 mmol/l at 24 h postoperatively, compared to other patients who did not require transfusion and ICU admission (<i>P</i> < 0.001). The bicarbonate value did not show any significant change from its baseline (22.68 ± 1.83 mEq/l) at all time points (<i>P</i> = 0.8). In addition, no significant difference was noted regarding ICU admissions (<i>P</i> = 0.659) or blood transfusions (<i>P</i> = 0.788).</p><p><strong>Conclusions: </strong>Following major head and neck surgeries, blood lactate level is a good predictor, but bicarbonate is a poor predictor of the need for blood transfusions and ICU admission. Intraoperative blood transfusion failed to prevent rise in blood lactate level, which is taken as a surrogate marker of tissue hypoxia.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"164-170"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomised controlled trial to compare tracheal extubation quality in lateral and supine positions after general anaesthesia in children.","authors":"Anuradha Ganigara, D A Bhavana, Y R Chandrika, Trishi Sharma","doi":"10.4103/joacp.joacp_506_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_506_23","url":null,"abstract":"<p><strong>Background and aims: </strong>Tracheal extubation after general anaesthesia in pediatrics is a critical event, with sparse research on positioning of patient during extubation. Clinical data reveal lesser airway obstruction in the lateral position with enhanced airway patency. We studied the effects of supine versus lateral positioning on the quality of tracheal extubation as judged by the modified Minogue cough score in children undergoing elective surgeries under general anaesthesia. Secondary objectives included frequency of incidences of oxygen desaturation (SPO2 <92%), laryngospasm, bronchospasm, and stridor.</p><p><strong>Material and methods: </strong>In this single-blinded randomised trial, 110 children in the age group of 2-12 years were enrolled to be positioned in either the lateral (group L) or supine (group S) position during extubation at the end of surgery. All patients received a standardised anaesthesia regimen. Chin lift and positive pressure ventilation were instituted if airway patency was noted to be compromised during extubation. Vital parameters, extubation quality, sedation score, incidence of oxygen desaturation, laryngospasm, stridor, and bronchospasm were recorded every 5 minutes till 30 minutes post extubation.</p><p><strong>Results: </strong>Children in group S were noted to have a higher cough score at the 15^th minute post extubation with a <i>P</i> value of 0.04 compared to children in group L. Children in group L had a 18% incidence of adverse respiratory events compared to 30% in group S with a relative risk of 1.67.</p><p><strong>Conclusions: </strong>Positioning children in the lateral position during extubation resulted in improved extubation quality as evidenced by lower cough scores with fewer incidence of complications in comparison to supine position extubation.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"176-182"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of anesthesia for photoimmunotherapy.","authors":"Sunil Rajan, Nikita Saji, Maharnab Bhuyan, Lokeshshiva Arul","doi":"10.4103/joacp.joacp_500_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_500_23","url":null,"abstract":"","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"203-204"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy and safety of continuous transmuscular quadratus lumborum block for postoperative analgesia after laparoscopic nephrectomy: A prospective randomized clinical trial.","authors":"Kamlesh Kumari, Nidhi Jain, Darshana K Rathod, Rashmi Syal, Tanvi Meshram, Ankur Sharma, Manbir Kaur, Mahendra Singh, Pradeep Bhatia","doi":"10.4103/joacp.joacp_469_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_469_23","url":null,"abstract":"<p><strong>Background and aims: </strong>Analgesic efficacy and safety of continuous catheter technique in transmuscular quadratus lumborum block (QLB3) for laparoscopic nephrectomy has not been studied. This study was planned to evaluate the efficacy and safety of ultrasound (US)-guided continuous QLB3 for postoperative analgesia after laparoscopic nephrectomy.</p><p><strong>Material and methods: </strong>In this randomized, open-label, single-centered trial, 64 patients belonging to the American Society of Anesthesiologists, physical status grade I and II, 18-65 years of age, scheduled for laparoscopic nephrectomy were included. Patients were randomized into the QLB group and the control group. After surgery, the QLB group received transmuscular QLB with a 0.4 mL/kg bolus of 0.25% ropivacaine and catheter insertion for continuous infusion of 0.25% ropivacaine at 0.1 mL/kg/h. Patients in both groups received fentanyl (0.5 μg/kg) as rescue analgesia by IV PCA pump.</p><p><strong>Results: </strong>The data of 30 patients in each group were analyzed. Total fentanyl consumption during the first 48 h postoperatively was significantly lower in the QLB group compared to the control group (mean ± SD; QLB group = 74.33 ± 32.75 μg; control group = 209.10 ± 52.04 μg) (<i>P</i> < 0.001). Postoperative NRS pain scores at rest and on movement were significantly lower in the QLB group compared to the control group at various time intervals up to 48 h postoperative (<i>P</i> < 0.05). No severe complications were seen in any of the patients.</p><p><strong>Conclusions: </strong>US-guided continuous catheter transmuscular QLB reduced postoperative opioid consumption by 64.45% and decreased NRS pain scores after laparoscopic nephrectomy without complications.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"158-163"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of ultrasound measured tongue thickness, tongue thickness-thyromental distance ratio, and skin-to-epiglottis distance in predicting unanticipated difficult laryngoscopy.","authors":"Amit Rastogi, Abhijeet Kumar Singh, Divya Srivastava, Ashish Kumar Kannaujia, Tapas K Singh, Prabhaker Mishra","doi":"10.4103/joacp.joacp_423_23","DOIUrl":"https://doi.org/10.4103/joacp.joacp_423_23","url":null,"abstract":"<p><strong>Background and aims: </strong>The contemporary literature review suggests upper airway ultrasound can help us to diagnose an unanticipated difficult airway before laryngoscopy. The primary objective of this study was to compare ultrasonography (USG) and clinical airway indices across easy and difficult laryngoscopy groups.</p><p><strong>Material and methods: </strong>This prospective observational study included 258 patients scheduled to undergo surgery under general anesthesia with endotracheal intubation. Ultrasonographic upper airway parameters, viz., tongue thickness (TT), skin-to-epiglottis distance (DSE), and tongue thickness to thyromental distance ratio (TT/TMD) were measured. Patients were identified as easy or difficult laryngoscopy groups based on their Cormack Lehane (CL) grading.</p><p><strong>Results: </strong>Out of 258 patients, 20 (7.75%) had difficult laryngoscopy, and 238 (92%) had easy laryngoscopy. The USG measured TT mean, and median values were 6.16 ± 0.39 [6.10] cm in difficult and 5.41 ± 0.36 [5.40] cm in easy laryngoscopy groups. The USG measured mean and median value of DSE were 2.75 ± 0.09 [2.74] in difficult and 2.27 ± 0.23 [2.27] in easy laryngoscopy groups. The ratio of TT/TMD with mean and median values of 0.98 ± 0.07 [0.99] in difficult and 0.84 ± 0.13 [0.82] in easy laryngoscopy. Using the inputs, the diagnostic accuracy of the ultrasound-measured significant variables was calculated in terms of their area under the curve using the receiver operating characteristic curve.</p><p><strong>Conclusions: </strong>This study revealed a relationship between sonographic measurements like TT, DSE, and TT/TMD ratio for easy and difficult laryngoscopy identification. Including these sonographic parameters and their cut-off values may enhance our ability to predict an unanticipated difficult laryngoscopy.</p>","PeriodicalId":14946,"journal":{"name":"Journal of Anaesthesiology, Clinical Pharmacology","volume":"41 1","pages":"151-157"},"PeriodicalIF":1.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}