The Role of Anthropometric Measurements and Ultrasonograpic Suprasternal Adipose Tissue Thickness

NCT ID: NCT06457165

Last Updated: 2024-06-14

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 40 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2021-01-01
• Study Completion Date: 2024-01-01

Brief Summary

Prediction of difficult preoperative intubation in obese patients and completion of preparations for difficult intubation both reduce the risk of repeated intubation and prevent complications.

In this study, the investigators aimed to evaluate whether anthropometric measurements are superior in defining difficult preoperative airways.

Detailed Description

The World Health Organization (WHO) defines obesity, the incidence of which has increased significantly worldwide and is one of the important causes of difficult airway in terms of anesthesia, as obesity when the body mass index (BMI) is above 30. Access to the upper airway is difficult in obese patients, in whom excessive adipose tissue accumulates in the breast, neck, chest, and abdomen. Determining preoperative difficult intubation parameters in obese patients and entering the case preparation both reduce the risk of repeated intubation and prevent intraoperative and postoperative complications.

However, there are still insufficient tests to predict difficult intubation. Many studies have shown that multiple factors such as Mallampati score, high body mass index (BMI), increased neck circumference, and the ratio of neck circumference to thyromental distance are predictors of difficult intubation in obese patients. The introduction of ultrasonography into daily use has led to the use of ultrasonographic parameters in predicting difficult intubation and laryngoscopy. In this study, the investigators aimed to evaluate whether ultrasonography is useful in defining difficult preoperative airways, in addition to anthropometric measurements.

Conditions

Intubation; Difficult or Failed; Obesity; Anesthesia

Study Design

• Observational Model Type: OTHER
• Study Time Perspective: PROSPECTIVE

Study Groups

Difficult Intubation

Abdominal circumference, waist circumference, arm circumference, distance between incisions,TMD and SMD measurements, Mallampati test, Wilson score, and suprasternal subcutaneous adipose tissue thickness were measured and recorded. ECG, SBP and DBP, and SpO2 monitoring were performed. Pre-oxygenation was performed using a 100% oxygen face mask for 3 min before the induction of anesthesia. Induction of anesthesia was achieved with IV 1 mg/kg lidocaine, 0.125 mcgr/kg fentanyl, 2 mg/kg propofol, and 0.6 mg/kg rocuronium bromide. After 2 min of adequate muscle relaxation, the patient was intubated with an endotracheal tube of appropriate diameter. Cormack-Lehane score was evaluated during laryngoscopy. Patients with more than 3 intubation attempts by an experienced anesthesiologist were considered difficult to intubate. In maintenance, 0.1 mcg/kg/h remifentanil was administered in sevoflurane O2-air mixture.

Age, sex, body weight,BMI, and ASA scores were recorded.

Difficult Intubation

Intervention Type: DEVICE

Noted for each patient.

Not Difficult Intubation

Intervention Type: DEVICE

Noted for each patient.

Not Difficult Intubation

Abdominal circumference, waist circumference, arm circumference, distance between incisions,TMD and SMD measurements, Mallampati test, Wilson score, and suprasternal subcutaneous adipose tissue thickness were measured and recorded. ECG, SBP and DBP, and SpO2 monitoring were performed. Pre-oxygenation was performed using a 100% oxygen face mask for 3 min before the induction of anesthesia. Induction of anesthesia was achieved with IV 1 mg/kg lidocaine, 0.125 mcgr/kg fentanyl, 2 mg/kg propofol, and 0.6 mg/kg rocuronium bromide. After 2 min of adequate muscle relaxation, the patient was intubated with an endotracheal tube of appropriate diameter. Cormack-Lehane score was evaluated during laryngoscopy. Patients with more than 3 intubation attempts by an experienced anesthesiologist were considered difficult to intubate. In maintenance, 0.1 mcg/kg/h remifentanil was administered in sevoflurane O2-air mixture.

Age, sex, body weight,BMI, and ASA scores were recorded.

Difficult Intubation

Intervention Type: DEVICE

Noted for each patient.

Not Difficult Intubation

Intervention Type: DEVICE

Noted for each patient.

Interventions

Difficult Intubation

Noted for each patient.

Intervention Type: DEVICE

Not Difficult Intubation

Noted for each patient.

Intervention Type: DEVICE

Other Intervention Names

Age; ASA; BMI; Arm circumference; TMD; SMD; Distance between incisions; Abdominal circumference; Waist circumference; Suprasternal adipose tissue thickness; Mallampati; Cormack-Lehane score; Wilson score; Age; ASA; BMI; Arm circumference; TMD; SMD; Distance between incisions; Abdominal circumference; Waist circumference; Suprasternal adipose tissue thickness; Mallampati; Cormack-Lehane score; Wilson score

Eligibility Criteria

Inclusion Criteria

• 18-60 years
• ASA 1-3
• BMI ≥30 kg/m2
• ASA 1-3
• Scheduled for elective abdominal surgery under general anesthesia

Exclusion Criteria

• <18 and >60 years
• ASA>3
• BMI<30

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Ankara City Hospital Bilkent

OTHER

Sponsor Role: lead

Responsible Party

Ayça Özcan

Assoc. Prof. MD

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Ayça Tuba Dumanlı Özcan

Role: PRINCIPAL_INVESTIGATOR

Ankara City Hospital Bilkent

Locations

Ankara Bilkent City Hospital

Ankara, , Turkey (Türkiye)

Countries

Turkey (Türkiye)

Other Identifiers

Difficult Intubation

Identifier Type: -

Identifier Source: org_study_id