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Abstract

Unanticipated difficult tracheal intubation is a significant source of morbidity and mortality in anesthetized patients. A number of modules have been developed to predict difficult airways, but they are often complex in nature. Aim of this study to determine the accuracy of the modified Mallampati test for predicting difficult tracheal intubation before induction of anesthesia by using the Mallampati scores and other parameters such as BMI, difficult mask ventilation. Fifty adult patients were prospectively analyzed of the American Society of Anesthesiologists (ASA) class I or II. All adult patients (> 18 years) presenting for any type of non-emergency surgical procedures under general anesthesia that required endotracheal intubation were enrolled. Mallampati test was performed prior to anesthesia. Following induction of anesthesia, the anesthesiologist was described the laryngoscopic view using the Cormack-Lehane scale. Classe 3 or 4 of the Mallampati test were considered as a predictor of difficult intubation. Grades 3 or 4 of the Cormack-Lehane classifications of the laryngoscopic view were defined as impaired glottic exposure. A purposive (non-probability) samples of (50) patients enrolled in this study conducted in a Specialized Surgeries Hospital “Gazi AL-Harrery Hospital” in Baghdad city, 12 had difficult intubation (24%) and 38 had easy intubation (76%). The sensitivity of the Mallampati classifications in four grades shown a significant difference but the specificity was found to be the highest in the grades 2. The Mallampati test is of limited value in predicting difficult intubation when was used as a single examination, also observed other parameters which had effect on the difficulty of intubation like obesity, thyromental distance, mouth opening, presence of receding mandible, cervical mobility and other deformities.

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