Omparison Of Upper Lip Bite Test With Modified Mallampati Test For Predicting Difficulty In Endotracheal Intubation : A Prospective Study

Abstract

Background : Airway management is of prime importance to the Anaesthesiologist . Unexpected difficulty with endotracheal intubation is a significant contributor to anaesthetic morbidity and mortality in clinical practice . In order to avoid complications , there has been a continuous search for better predictor of difficult airway , ULBT is one such attempt . Objectives : To compare sensitivity , specificity , positive predictive value and negative predictive value of ULBT and MMT to predict difficulty in endotracheal intubation . Methods : One hundred and forty patients , aged between 16 yrs to 55 yrs of age of both sexes scheduled for various elective surgeries under general anaesthesia after meeting inclusion and exclusion criteria were enrolled in this prospective study . Pre operatively patients airway was evaluated by both MMT and ULBT . MMT class III and IV, ULBT class III were considered as predictors of difficult endotracheal intubation . On the day of surgery , after premedication and induction laryngoscopy was performed in sniffing position . The glottic views were graded according to the Cormack and Lehane classification. Patients of Cormack Lehane class III / IV were considered as difficult to intubate. Results : Incidence of difficult intubation in our study was found to be 5% .MMT was found to be more sensitive. But, positive and negative predictive value of both the tests were comparable . IX Conclusions : MMT is a better predictor of difficult endotracheal intubation when compared to ULBT and both the tests are better predictors of easy intubations than of difficult intubation .