Turkish journal of anaesthesiology and reanimation最新文献

{"title":"The First Hundred Years of the Scientific Field of Anaesthesiology and Reanimation in the Republic of Turkey.","authors":"Hatice Türe, Haluk Gümüş","doi":"10.4274/TJAR.2023.231387","DOIUrl":"10.4274/TJAR.2023.231387","url":null,"abstract":"<p><p>As a scientific field, anaesthesiology and reanimation, with their significant place in the medical structure, have been practised since the beginning of surgical procedures. Today anaesthesiology and reanimation speciality cover more complex techniques and areas than alleviating patients' pain during surgery. In the first hundred years since the proclamation of the Turkish Republic, the path covered in our scientific field is to pave the way for the next hundred years.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 6","pages":"459-464"},"PeriodicalIF":0.5,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10758668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040559","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":"Duties of Anaesthetists and Assessment of Awareness, Concerns, and Expectations on Anaesthesia Practices.","authors":"Melahat Yalçın Solak, Murat İzgi, Murat Tümer, Şennur Uzun","doi":"10.4274/TJAR.2023.231328","DOIUrl":"10.4274/TJAR.2023.231328","url":null,"abstract":"<p><strong>Objective: </strong>Numerous studies performed worldwide indicate that the public has limited knowledge of anaesthesia practices and anaesthetists' duties and responsibilities. This study aimed to identify the level of knowledge about anaesthetists and anaesthesia practices, and to assess the reasons for anxiety about anaesthesia of the population admitted to our hospital, which is tertiary in Turkey. The secondary aim was to analyze their differences according to sex, education level, and acquired anaesthesia experience.</p><p><strong>Methods: </strong>A survey comprising 23 questions was administered to 400 patients and/or their relatives, aged 18-85 years, who presented to our clinic for preoperative anaesthesia evaluation and for whom elective surgery was planned from March through October 2017.</p><p><strong>Results: </strong>Of the 400 participants, 213 were women and 187 were men. Of all participants in the survey, 51.2% were patients and 48.8% were patient relatives; 64.2% had anaesthesia experience and 35.8% had never had anaesthesia before. The survey group's level of knowledge about anaesthesia was generally low. According to education level, there was a statistically significant difference in the anaesthesia recognition level. However, the acquired anaesthesia experience did not affect the anaesthesia recognition level.</p><p><strong>Conclusion: </strong>To raise the level of knowledge about this topic, anaesthetists must provide patients with more detailed information during preoperative and postoperative visits, which would significantly reduce their anxiety levels. Further, we determined that increasing the use of methods such as media-based brochures, booklets, and videos to inform patients may increase knowledge levels and reduce anxiety levels.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 6","pages":"477-484"},"PeriodicalIF":0.5,"publicationDate":"2023-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10758674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139040553","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":"Continuous Serratus - Intercostal Plane Block for Perioperative Analgesia in Upper Abdominal Surgeries: A Prospective Randomized Controlled Study.","authors":"Mohamed A Mamoun,&nbsp;Alrefaey K Alrefaey,&nbsp;Maha Ahmed Abo-Zeid","doi":"10.4274/TJAR.2023.231260","DOIUrl":"10.4274/TJAR.2023.231260","url":null,"abstract":"<p><strong>Objective: </strong>Acute pain management after open abdominal surgeries is an essential goal in perioperative management.. Recently, serratus-intercostal plane block (SIPB) was suggested as an analgesic technique for upper abdominal surgeries.</p><p><strong>Methods: </strong>This prospective, randomized, controlled study included sixty adult patients scheduled for open upper abdominal surgeries. Patients were allocated into two equal groups: SIPB group (S group, n = 30) and control group (the C group, n = 30). In the S group, SIPB was performed in the midaxillary line at the eighth rib level followed by continuous infusion of local anaesthetic for the first postoperative day. In the C group, no block was done. The primary objective of the study was to control postoperative pain on the first postoperative day as assessed by the numerical rating scale (NRS). Secondary outcomes included perioperative hemodynamics, total postoperative analgesic consumption, number of analgesic requests, and incidence of postoperative nausea and vomiting.</p><p><strong>Results: </strong>The mean postoperative NRS reported in group S was statistically lower than that in group C (2.4±0.7, 3.9±0.31, <i>P</i> < 0.001). The postoperative morphine consumption was lower in the S group than in the C group [(0 (0-4), 3 (1-4), respectively, <i>P</i> < 0.001]. The incidence of PONV was significantly lower in the S group than in the C group (16.7% and 40%, <i>P</i> < 0.045).</p><p><strong>Conclusion: </strong>SIPB was associated with a better analgesic profile compared with the control group after upper abdominal surgeries. Further studies are recommended to determine block safety in special patient groups, including bariatric and laparoscopic surgeries.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 5","pages":"402-407"},"PeriodicalIF":0.5,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10606739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50158843","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":"Effect of Preoperative Anxiety on Depth of Anaesthesia and In Vitro Fertilization Success.","authors":"Sevtap Hekimoğlu Şahin,&nbsp;Elif Çopuroğlu,&nbsp;Ece Yamak Altınpulluk,&nbsp;Necdet Süt,&nbsp;Beyhan Karamanlıoğlu,&nbsp;Koray Elter,&nbsp;Özge Yaman","doi":"10.4274/TJAR.2023.22829","DOIUrl":"10.4274/TJAR.2023.22829","url":null,"abstract":"<p><strong>Objective: </strong>Infertility anxiety may have a harmful effect on embryo quality and fertilization during in vitro fertilization (IVF). Monitoring brain function gives real-time information about the depth of anaesthesia of a patient. This study examined the effect of preoperative anxiety on the depth of anaesthesia and IVF success.</p><p><strong>Methods: </strong>One hundred thirty-one patients who had undergone oocyte retrieval were divided into two groups according to the Beck Anxiety Inventory (BAI): the low-anxious Group L (n = 71) and high-anxious Group H (n = 60). Hemodynamic stability, intraoperative total propofol and fentanyl consumption, good quality embryo (GQE) rate, and fertilization rate were recorded.</p><p><strong>Results: </strong>Fertilization and GQE rates were not significant between groups L and H. Total propofol consumption was significantly higher in group H than in group L. Heart rate (HR) preoperatively and postoperatively and systolic arterial pressure (SAP) preoperatively and diastolic arterial pressure (DAP) postoperatively were significantly increased in group H than in group L. The time for the modified Aldrete score to reach 9 (MAS 9) in group H was significantly higher than that in group L. The effect of variables that were found significantly in the univariate analysis (Propofol, HRpreop, HRpostop, SAPpreop, DAPpostop, and MAS 9) on BAI score.</p><p><strong>Conclusion: </strong>Total propofol consumption was higher in patients with high anxiety levels, but it did not have a negative effect on IVF success.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 5","pages":"414-419"},"PeriodicalIF":0.5,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10606735/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50158857","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":"Comparison of the Analgesic Efficacy of Ultrasound-Guided Quadratus Lumborum Block and Ilioinguinal-Iliohypogastric Nerve Block in Paediatric Patients After Inguinal Hernia Surgery: A Prospective Randomized Controlled Trial.","authors":"Mustafa Altınay,&nbsp;Hacer Şebnem Türk","doi":"10.4274/TJAR.2023.231289","DOIUrl":"10.4274/TJAR.2023.231289","url":null,"abstract":"<p><strong>Objective: </strong>To compare the postoperative analgesic efficacy of quadratus lumborum block (QLB) and ilioinguinal-iliohypogastric nerve block (IIIHB) in paediatric patients who have undergone unilateral inguinal hernia surgery.</p><p><strong>Methods: </strong>This prospective randomized controlled study was designed in a single center and included 60 paediatric patients aged 2-7 years who had undergone inguinal hernia repair surgery and received an American Society of Anesthesiologists score of 1-2. Patients were randomized into two groups: those receiving ultrasound-guided QLB and those receiving IIIHB. The primary outcomes of the study were patients' face, legs, activity, cry, and consolability (FLACC) scores at 1, 2, 6, 12, and 24 hours post-surgery.</p><p><strong>Results: </strong>The mean heart rate 15 and 30 minutes post-surgery in the QLB group was lower than that of the IIIHB group, and the difference at both times was statistically significant (<i>P</i> < 0.001). The mean FLACC score of the QLB group was lower than that of the IIIHB group at 6, 12, and 24 hours post-surgery, and the differences were statistically significant (<i>P</i>=0.004, <i>P</i>=0.006, and <i>P</i> < 0.001, respectively). Between the groups, there was no statistically significant difference in the number of patients who were administered rescue analgesics or oral ibuprofen, the time of first ibuprofen administration, or the frequency of complications (<i>P</i>=1.000, <i>P</i>=0.145, <i>P</i>=0.195, and <i>P</i>=1.000, respectively).</p><p><strong>Conclusion: </strong>Compared with IIIHB, QLB achieves superior postoperative analgesic effects in paediatric patients who have undergone inguinal hernia surgery, as evidenced by longer analgesic periods, lower pain scores, and lower analgesic consumption.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 5","pages":"443-449"},"PeriodicalIF":0.5,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10606743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50158841","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 Different Crystalloid Fluids on Renal Tissue in an Experimental Model of Hemorrhagic Shock.","authors":"Kemal Tolga Saraçoğlu,&nbsp;Ayten Saraçoğlu,&nbsp;Mehmet Yıldırım,&nbsp;Cumaali Demirtaş,&nbsp;Metehan Akça,&nbsp;Ferda Serdoğan,&nbsp;İlyas Samet Ergün,&nbsp;Şermin Tetik,&nbsp;Sadrettin Pençe","doi":"10.4274/TJAR.2023.231262","DOIUrl":"10.4274/TJAR.2023.231262","url":null,"abstract":"<p><strong>Objective: </strong>The type of fluid that should be used in uncontrollable hemorrhages remains an area of research. This study was designed to compare the effects of resuscitation with Ringer's lactate (RL) solution versus a normal saline (NS) solution on hemodynamics, renal tissue histopathology, coagulation, and apoptosis in a rat model of hemorrhagic shock.</p><p><strong>Methods: </strong>The study employed groups designated as the control, hemorrhage, NS, and RL groups. Heart rate, mean arterial pressure, and respiratory rate were monitored. Annexin A5 values were assayed, rotational thromboelastometry analysis was performed, and excised kidney tissue samples were histopathologically analyzed.</p><p><strong>Results: </strong>Blood pressure levels were found to be significantly higher in the control group than those measured in the other groups. While the clotting time (CT) and clot formation time (CFT) in the hemorrhage group were significantly longer than those in the control and RL groups, the CT and CFT measured in the control group were significantly shorter compared to the RL group. The mean Annexin A5 level was in the hemorrhage group, which was significantly higher compared to the other groups. In the renal histopathological evaluation, the scores of proximal tubular injury, distal renal tubular injury, and interstitial renal tubular injury were found to be significantly lower in the control group compared to the other groups.</p><p><strong>Conclusion: </strong>This study demonstrated that NS or RL can be used safely to improve the hemodynamic symptoms resulting from hemorrhagic shock as a means to reduce apoptosis, and to decrease findings in favor of coagulopathy in bedside coagulation tests during the early stages of hemorrhagic shock until the time of starting a blood transfusion.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 5","pages":"380-387"},"PeriodicalIF":0.5,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10606732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50158858","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":"Effect of Intravenous Ketamine Infusion on Hemodynamics of Patients Undergoing Cesarean Delivery after Spinal Anaesthesia: A Randomized, Double-Blind, Controlled Trial.","authors":"Mohamed Abdelgawad Abdelhalim Aboelsuod,&nbsp;Ahmed Mossad Ahmed Elnaggar,&nbsp;Tarek Abu Alkasem Abu Alwafa,&nbsp;Mostafa Mohamed Hussien Ahmed,&nbsp;Ahmed Salah Ahmed Elbeltagy,&nbsp;Mohamed Ibrahim Abdelkader Elbarbary","doi":"10.4274/TJAR.2023.231231","DOIUrl":"10.4274/TJAR.2023.231231","url":null,"abstract":"<p><strong>Objective: </strong>Hypotension is the most frequent side effect of intrathecal anaesthesia, with an incidence of more than 80%. Following neuraxial anaesthesia, perioperative shivering is a serious complication affecting 40-60% of patients undergoing surgery. This study aimed to determine the effectiveness of low-dose ketamine on blood pressure in patients undergoing cesarean delivery after spinal anaesthesia.</p><p><strong>Methods: </strong>We included 126 female patients undergoing cesarean deliveries, American Society of Anesthesiologists (ASA)-(II and III), and aged 21-40 selected from the outpatient clinics of the anaesthesia department. Patients were randomized to two groups; Group K (63 patients), who received 0.3 mg kg^-1 of ketamine IV diluted to 10 mL, followed by an infusion of 0.1 mg kg^-1 h^-1. Group C (Controlled) (63 patients) received 10 mL of normal saline, followed by an infusion of 0.1 mL kg^-1 h^-1, which started before spinal anaesthesia.</p><p><strong>Results: </strong>Compared with the saline group, the average heart rate, blood pressure, and level of sedation were significantly higher in the ketamine group (<i>P</i> < 0.05). The ketamine group reported a significantly lower incidence of shivering (<i>P</i> < 0.01). The ketamine groups exhibited significantly less mild or severe hypotension (<i>P</i> < 0.05). There was no significant difference between the two groups in terms of nystagmus, diplopia, hallucinations, or neonatal outcomes (<i>P</i> > 0.05).</p><p><strong>Conclusion: </strong>Ketamine decreases the incidence of hypotension and shivering in patients undergoing spinal anaesthesia during cesarean delivery. In addition, it resulted in improved sedation for the mother and prolonged postoperative analgesia without neonatal illness.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 5","pages":"420-426"},"PeriodicalIF":0.5,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10606733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50158856","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 Anaesthetic Approaches in Transcatheter Aortic Valv Implantation Procedures.","authors":"Murat İzgi, Adem Halis, Yusuf Ziya Şener, Levent Şahiner, Ergün Barış Kaya, Kudret Aytemir, Ayşe Heves Karagöz","doi":"10.4274/TJAR.231270","DOIUrl":"10.4274/TJAR.231270","url":null,"abstract":"<p><strong>Objective: </strong>Transcatheter aortic valve implantation (TAVI) has emerged as an alternative to surgical aortic valve replacement and has become a popular treatment modality for inoperable or patients at high surgical risk with severe aortic stenosis. We aimed to evaluate our perioperative anaesthetic experiences with patients undergoing TAVI under sedation or general anaesthesia (GA).</p><p><strong>Methods: </strong>One hundred and fifty-nine patients who underwent TAVI procedures were enrolled. Effects on TAVI outcomes of sedation and GA were compared.</p><p><strong>Results: </strong>The duration of surgery and anaesthesia was significantly longer in patients who received GA. Insertion site complication and post-TAVI pacemaker implantation rates were similar between the groups, but the frequency of intraoperative complications (10% vs. 0.8%; <i>P</i>=0.015), intraoperative hypotension (35.3% vs. 70%; <i>P</i> < 0.001), and acute kidney injury (12.6% vs. 27.5%; <i>P</i>=0.028) was significantly higher in the GA group. Stroke occurred in seven patients, and all were in the sedation group.</p><p><strong>Conclusion: </strong>GA is related to increased procedure time and acute kidney injury; therefore, local anaesthesia and sedation may be the first option in patients undergoing TAVI.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 5","pages":"427-433"},"PeriodicalIF":0.6,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10606737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50158860","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":"Role of Preoperative Oral Rehydration Solution on Myocardial Ischaemia During Orthopaedic Surgery under Spinal Anaesthesia: A Prospective Randomised Study.","authors":"Hithish Mj,&nbsp;Gaurav Jain,&nbsp;Priyanka Gupta,&nbsp;Roop Bhushan Kalia,&nbsp;Praveen Talawar","doi":"10.4274/TJAR.2023.231206","DOIUrl":"10.4274/TJAR.2023.231206","url":null,"abstract":"<p><strong>Objective: </strong>Preoperative oral rehydration solution (ORS) supplementation offers wide postoperative benefits, but its role in reducing post-spinal myocardial ischaemia is uncertain. We evaluated this aspect in elective lower limb orthopaedic surgeries and compared it to conventional preoperative fasting.</p><p><strong>Methods: </strong>Prospectively, we randomised 126 patients aged >60 years into two groups: (A) received reconstituted ORS (1000 mL) during the overnight preoperative fasting, continued up to 2 hrs prior to spinal anaesthesia (SA) induction; (B) kept on conventional overnight preoperative fasting. This study evaluated electrocardiographic ischaemic changes at 2, 5, 10, 15, and 30 minutes after SA induction.</p><p><strong>Results: </strong>In total, 27 patients (group A: 7; group B: 20) developed transient electrocardiographic ischaemic changes. On intergroup comparison, group B had a significantly higher incidence at all time points, with highest statistical levels at 5- and 10-minutes ((<i>P</i> < 0.001). The receiver operating characteristic curve at a threshold fasting duration (fluids) of >3 hours, had an area-under-curve of 0.74 to predict such changes within 30 minutes of SA induction (sensitivity 96.30%, specificity 55.56%, accuracy 64.29%, odds ratio 32.50, relative risk 20.80, (<i>P</i> < 0.001). Post-spinal hemodynamic changes were higher in group B than in A; hypotension and tachycardia were statistically significant ((<i>P</i>=0.020). The pleth variability index was significantly higher ((<i>P</i> < 0.001), while perfusion index was significantly lower (<i>P</i> < 0.001) in group B at all time points.</p><p><strong>Conclusion: </strong>Preoperative ORS supplementation significantly reduced post-spinal transient ischaemic electrocardiographic changes in elderly patients than conventional overnight fasting.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 5","pages":"388-394"},"PeriodicalIF":0.5,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10606734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50158861","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":"Accuracy of Sonographic Airway Parameters in Difficult Laryngoscopy Prediction: A Prospective Observational Cohort Study from Central India.","authors":"S K Parameshwar,&nbsp;Sunaina Tejpal Karna,&nbsp;Vaishali Waindeskar,&nbsp;Harish Kumar,&nbsp;Pooja Singh,&nbsp;Saurabh Saigal","doi":"10.4274/TJAR.2023.231217","DOIUrl":"10.4274/TJAR.2023.231217","url":null,"abstract":"<p><strong>Objective: </strong>Though airway ultrasonography (USG) is used to assess difficult laryngoscopy (DL), there is still ambiguity about approach followed and parameters assessed. There is need of a simple, stepwise sonographic assessment with clearly defined parameters for DL prediction. The primary objective of this study was to find diagnostic accuracy of sonographic parameters measured by a stepwise Airway-USG in DL prediction (DLP).</p><p><strong>Methods: </strong>This prospective, observational cohort study was done in 217 elective surgical adult patients administered general anaesthesia with tracheal intubation using conventional laryngoscopy from 1^st May 2019 to 31^st July 2020, after ethical approval. A sagittal Airway-USG was done using 2-6 Hz transducer in three steps specifying probe placement and head position. Demographic, clinical and Airway-USG measurements were noted. Correlation of the clinical/sonographic parameters was made with Cormack-Lehane score on DL. After receiver operating characteristic curve plotting, the sensitivity, specificity, positive predictive value, negative predictive value (NPV) of DL was calculated for each parameter using open-epi software.</p><p><strong>Results: </strong>DL was observed in 19/217 patients. Airway-USG parameters of skin to epiglottis distance >2.45 cm, hyomental distance with head extension <5.13 cm, head neutral <4.5 cm, their ratio <1.18, maximum tongue thickness >3.93 cm and maximum skin to tongue distance >5.45 cm were statistically significant in predicting DL. DLP score with presence of >3 positive parameters showed 98% specificity, 98% NPV and 96% diagnostic accuracy to predict DL.</p><p><strong>Conclusion: </strong>DLP score derived from Airway-USG may be used as a screening and diagnostic tool for DL.</p>","PeriodicalId":23353,"journal":{"name":"Turkish journal of anaesthesiology and reanimation","volume":"51 5","pages":"434-442"},"PeriodicalIF":0.5,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10606741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50158840","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}