Abstract

Introduction: No anaesthesiologist like to face scenario of unanticipated difficult intubation, as it may cost patients life. Many tests are there to predict difficult intubation, amongst those tests Modified Mallampati test [MMT] is a gold standard test. Upper lip bite test [ULBT] is an acceptable option for predicting difficult intubation. Our study aimed to compare both the tests to predict difficult intubation. Objectives: To analyse positive predictive value (PPV), negative predictive value (NPV), sensitivity, specificity and accuracy of ULBT and MMT. To compare the results of both the tests to predict difficult intubation. Aim: To ascertain whether ULBT can be incorporated in standard protocol of airway assessment along with other tests to increase predictive accuracy of difficult endotracheal intubation Materials and Methods: It was prospective randomised comparative observational study carried out at single centre. Three hundred patients of either sex, aged between 16-60 yrs scheduled for elective surgery under general anaesthesia with endotracheal intubation were enrolled in the study. Preoperative evaluation of airway was done with ULBT and MMT and findings were documented.MMT class III,IV and ULBT class III were considered as predictors of difficult intubation. On the day of the surgery after direct laryngoscopy laryngeal view was noted and was classified according to Cormack and Lehane classification. Patients with Cormack Lehane class III,IV considered as difficult to intubate. Cormack Lehane classification (C &L class) redings were compared with ULBT and MMT. Observations and Results: Demographic data and ASA grade was same for both the groups as participants were same. By comparing ULBT with Cormack and Lehane score we got 88.46% sensitivity, 92.74% specificity, 71.87% Positive predictive value (PPV), 97.45% ne gative predictive value (NPV) and 92% accuracy. For MMT we go t 19.23% sensitivity, 91.93% specificity, 33.33% PPV, 84.44% NPV a nd 79.33% acc

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