Neck Circumference as Sole Predictor of Cormack-Lehane Score and Difficult Intubation

Muhammad Abuzar Shakeel; Shahbaz Afsar Khan; Syed Qasim Ali  Shah; Bilal Yasin; Ahmed Hassam  Bhalli; Hajra Maryam  Muhammad

doi:10.51253/pafmj.v75iSUPPL-5.8636

Authors

Muhammad Abuzar Shakeel Department of Anesthesia, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Shahbaz Afsar Khan Department of Anesthesia, Combined Military Hospital Abbottabad /National University of Medical Sciences (NUMS) Pakistan
Syed Qasim Ali Shah Department of Anesthesia, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Bilal Yasin Department of Anesthesia, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Ahmed Hassam Bhalli Department of Anesthesia, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Hajra Maryam Muhammad Department of Anesthesia, Combined Military Hospital Rawalpindi/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75iSUPPL-5.8636

Keywords:

Neck circumference; endotracheal intubation; Intubation Difficulty Scale.

Abstract

Objective: To determine if higher neck circumference correlates with greater Cormack-Lehane score and difficulty in intubation among patients undergoing orthopaedic surgery under general anaesthesia.

Study Design: Prospective longitudinal study

Place and Duration of Study: Combined Military Hospital, Rawalpindi, Pakistan from April to July, 2021.

Methodology: ASA I and II adult patients undergoing elective orthopaedic surgery planned under general anaesthesia who had a neck circumference greater than 40 cm were included in the study. Non-randomized, consecutive sampling was used and all eligible patients during the study period were included. Neck circumference at the level of the thyroid cartilage was measured by the resident during pre-anaesthesia assessment. Modified Cormack-Lehane Score (MCLS) for each patient was determined either by the senior (third or fourth year) resident or the consultant on duty. All intubations were performed either by a senior resident or the consultant. Intubation Difficulty Scale (IDS) score of 5 or more was considered a difficult intubation.

Results: 55 patients, of which 28(50.9%) were female, were included in the study. Mean age was 36.89±14.08 years. Mean neck circumference was 43.14±1.63 cm. 37(67.3%) had MCLS grade 2b or higher while 20(36.4%) had IDS score of 5 or higher. Greater neck circumference was found to be significantly associated with a higher MCLS grade (p=0.012) but not with a higher IDS score (p=0.055).

Conclusion: Neck circumference could have predictive value for MCLS grade but not directly for IDS score. Further studies are needed to determine utility of NC as sole predictor of difficult intubation.

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