부산대학교 도서관

The aim of this study was to explore standard anthropometric airway characteristics of patients with obstructive sleep apnea syndrome (OSAS) and determine the incidence and risk factors for difficult airway management. Final analysis included 91 patients with polysomnography-verified diagnosis of OSAS who underwent sleep breathing disorder surgery under general anesthesia with direct laryngoscopy oroendotracheal intubation. The incidence of difficult manual mask ventilation during anesthesia induction, difficult intubation and immediate postextubation respiratory complications was 17.6%, 7.7% and 7.7%, respectively. Compared to patients without difficult manual mask ventilation, the group of OSAS patients with difficult manual mask ventilation had a higher rate of body mass index (BMI) [greater than or equal to]25 kgm-2 (p=0.010), Mallampati score [greater than or equal to]3 (p=0.024) and Cormack-Lehane score [greater than or equal to]3 (p=0.002). The OSAS patients with difficult intubation had more Cormack-Lehane score [greater than or equal to]3 (p=0.002) in comparison to those without difficult intubation. Our study demonstrated that manual mask ventilation during anesthesia induction was the most troublesome airway management task in OSAS patients during sleep breathing disorder surgery. Cormack-Lehane score was a relevant determinator of difficult mask ventilation and difficult intubation, while Mallampati score and BMI were relevant determinators only for difficult manual mask ventilation. Key words: Airway management; Sleep apnea, obstructive; Intubation; Ventilation; Anesthesia, general Cilj ovoga istrazivanja bio je odrediti standardna antropometrijska obiljezja disnoga puta u bolesnika sa sindromom opstruktivne apneje pri spavanju (OSAS), utvrditi incidenciju i rizicne cimbenike zbrinjavanja otezanoga disnog puta. Zavrsna analiza je ukljucivala 91 bolesnika s potvrdenom dijagnozom OSAS polisomnografjom, koji su bili podvrgnuti kirurskom zahvata poremecaja disanja kod spavanja u opcoj anesteziji s oroendotrahealnom intubacijom. Ucestalost otezane manualne ventilacije maskom tijekom uvoda u anesteziju, otezane intubacije i neposredne poslijeekstubacijeke komplikacije su bile slijedom 17,6%, 7,7% i 7,7%. U usporedbi s bolesnicima bez otezane manualne ventilacije maskom skupina bolesnika s OSAS i otezanom manualnom ventilacijom na masku je cesce imala indeks tjelesne mase ( ITM) [greater than or equal to]25 kg[m.sup.-2] (p=0,010), Mallampatijevu ocjenu [greater than or equal to]3 (p=0,024) i Cormack- Lehaneovu ocjenu [greater than or equal to]3 (p=0,002). Bolesnici s OSAS i otezanom intubacijom su cesce imali Cormack-Lehaneovu ocjenu [greater than or equal to]3 (p=0,002) u usporedbi s onima bez otezane intubacije. Nase istrazivanje je pokazalo da je najproblematicniji zadatak zbrinjavanja disnoga puta u bolesnika podvrgnutih kirurgiji poremecaja disanja kod spavanja manualna ventilacija na masku tijekom uvoda u anesteziju. Cormack-Lehaneova ocjena je relevantni rizicni cimbenik za otezanu ventilaciju na masku i otezanu intubaciju, dok su Mallampatijeva ocjena i ITM bili relevantni rizicni cimbenici samo za otezanu ventilaciju na masku. Kljucne rijeci: Zbrinjavanje disnog puta; Apneja pri spavanju, opstruktivna; Intubacija; Ventilacija; Anestezija, opca
Introduction Airway management during general anesthesia for undergoing surgery is a continuous and particularly important process that includes different airway techniques for different airway management stages. The most critical parts [...]