Difficult intubation predictors in obstructive sleep apnea patient

Abstract

OSArefers to a chronic condition of sleeping disorders affecting breathingdue to the presence of upper airway obstruction, and episodic attacks of apnea or hypopnea during sleep. In anesthesia of OSA cases, the essential worry of the vast majority of anesthetists is to assess the airway due to the elevated risk of DTI (Difficult tracheal intubation) in comparison with the normal individuals. According to American society of anesthesiology, DTI refers to trials to intubate the patient for > 2 times or trials lasting >10 min by qualified anesthesiologist. The clinical tests for prediction of DTI aren’t efficient in OSA patients. However, the measurement of NC (neck circumference), MP (Mallampati) scoring and TM (thyromental) distance are helpful as a part of preoperative airway assessment; yet can’t be applied in emergency or critical care as the patient is usually not cooperative to follow instructions. There are two intubation techniques: Primary which include direct, indirect and awake fibrotic intubation (AFOI). Secondary intubation techniques. SAD has a pivotal function during managing cases having difficult airways. Potential uses of ultrasound are to predict difficult intubation, diagnose OSA, confirm endotracheal tube placement, predict efficient extubation, in addition to US-guided superior laryngeal nerve block.