Determination of Anthropometric Measurements that may be Associated with Difficult Intubation in Children

Abstract

Aim: Difficult tracheal intubation is a fundamental cause of perioperative morbidity and mortality. The frequency of difficult intubation is thought to be higher in the pediatric age group due to the different anatomical and physiological structures, and it may not be easy to detect this beforehand. Anthropometric measurements were evaluated before the elective operation and the relationship of some parameters with difficult intubation.
 Material and Method: This prospective cross-sectional study was conducted on 90 pediatric patients aged 2-14 who underwent elective surgery under general anesthesia. All patients’ age, gender, height, weight, body surface area (BSA), and body mass index (BMI) records were recorded before the operation. Mallampati scoring, head and neck circumference, thyromental distance measurements, and head circumference/neck circumference ratio were performed. Cormack-Lehane (CL) scoring and endotracheal intubation were applied during direct laryngoscopy of the operated patients. Children with easy intubation (CL grade 1 and 2) group 1; children who underwent difficult intubation (CL grade 3 and 4) were defined as group 2.
 Results: There was no significant relationship between Groups I and II in terms of age, height and weight values. There was no significant relationship between the two groups with BSA and thyromental distance measurements. Mallampati scores were found to be grades 3 and 4 (3.3%) in three of the 90 patients, and CL scores of 3 and 4 (4.4%) in four patients. A significant correlation was found between Mallampati scoring and CL scoring. A statistically significant difference was found between the two groups regarding head/neck ratios and BMI.
 Conclusion: In our study, head circumference/neck circumference ratio and BMI were found to be helpful while predicting difficult intubation in children with normal physical characteristics, 2-14 years of age, who underwent elective surgery. Our findings can be supported by further studies that will be planned and include more patients.