J Otolaryngol Ophthalmol Shandong Univ ›› 2017, Vol. 31 ›› Issue (6): 62-67.doi: 10.6040/j.issn.1673-3770.0.2017.396

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Predictors of difficult airway in patients with obstructive sleep apnea-hypopnea syndrome during general anesthesia.

LI Ling1, WANG Chunling1, ZHANG Li1, LI Yanzhong2.   

  1. Department of Anesthesiology;2. Department of Otorhinolaryngology, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Received:2017-09-18 Online:2017-12-16 Published:2017-12-16

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Abstract: Objective This study aimed to find predictors for difficult mask ventilation and intubation in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS), and to decrease the incidence of difficult airway during general anesthesia. Methods Based on the inclusion criteria, 128 OSAHS patients diagnosed by polysomnography were included in the study. After general anesthesia induction, the incidence of difficult mask ventilation and difficult intubation were recorded; patient characteristics were also documented. Univariate analyses were performed to identify the potential risk factors for difficult mask ventilation and difficult intubation. Factors identified as having a significant association with difficult mask ventilation and difficult intubation were then subjected to stepwise multiple logistic regression analysis, to evaluate confounding among these predictors. Results Difficult mask ventilation was present in 64.8%(83/128)of the OSAHS patients; the rate of difficult intubation was 51.6%(66/128). The univariate analyses showed that difficult mask ventilation was associated with body mass index(BMI), apnea-hypopnea index(AHI), neck circumference(NC), waist circumference(WC), neck circumference to height ratio(NC/H), waist circumference to height ratio(WC/H), Mallampati score, and Cormack and Lehane classification. Multiple logistic regression analysis showed that BMI, NC, Mallampati score, and Cormack and Lehane classification were independent predictors of difficult mask ventilation. Difficult intubation was associated with BMI, the lowest oxygen saturation(LSaO2)level, AHI, WC, WC/H, interincisor distance(ICD), Mallampati score, and Cormack and Lehane classification. Multiple logistic regression analysis showed that AHI and Cormack and Lehane classification were independent predictors of difficult intubation; ICD was the protective factor for difficult intubation. Conclusion OSAHS patients presented with a high risk of difficult airway. BMI, NC, Mallampati score, and Cormack and Lehane classification were independent predictors of difficult mask ventilation. AHI, ICD, and Cormack and Lehane classification were 山东大学耳鼻喉眼学报31卷6期 -李玲,等.阻塞性睡眠呼吸暂停低通气综合征患者手术麻醉中困难气道发生的因素预测 \=-strongly linked with difficult intubation.

Key words: Anesthesia, Difficult mask ventilation, Difficult intubation, Acute respiratory obstruction, Obstructive sleep apnea hypopnea syndrome

CLC Number: 

  • R766.7
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