بازنگری طبقهبندی راههوایی بهروش Cormack و Lehane با توجه ویژه بر یافتههای گرید ΙΙ
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Abstract:
Background: The major responsibility of an anesthesiologist is to provide adequate respiration for the patient. The most vital element in providing functional respiration is the airway. No anesthetic is safe unless diligent efforts are devoted to maintaining an intact functional airway. Difficult intubation had been classified into four grades, according to the view obtainable at laryngoscopy by Cormack and Lehane in 1984. This grading system has been in use to evaluate and manage those patients with difficult airway by anesthesiologists. In clinical state, grades III and IV are quite rare, so the need for a modified Cormack and Lehane grading system was felt. The use of a modified Cormack-Lehane scoring system of laryngoscopic views during direct laryngoscopy, was previously examined in the Western population. Koh and his co-workers had examined this modified Cormack and Lehane grading system in Asian population in a study in Singapore General Hospital. The aim of this study was to investigate this scoring system in Iranian patients.Methods: In a cross sectional study, a modified version of the Cormack and Lehane grading system was evaluated in 300 patients requiring tracheal intubation. In the modified system, grade II (only part of the glottis is visible) was divided into IIa (part of the cords is visible) and IIb (only the arytenoids or the very posterior origin of the cords are visible). Difficult intubation was defined as requiring more than one laryngoscopy or the use of special equipments.Results: Sixty eight patients (22.7%) were scored as grade IIa and 32 (7.7%) as grade IIb. The prevalence of difficult intubation in grade IIb was significantly higher than patients in group IIa (47.8% vs. 2.9% respectively, Fisher's exact test, p= 0.001)Conclusion: The modified grading system provides more information than the original Cormack and Lehane system.
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full textUltrasonographic modification of Cormack Lehane classification for pre-anesthetic airway assessment.
BACKGROUND The major drawback of Cormack Lehane classification for airway assessment is its dependence on invasive direct laryngoscopy and hence it is inapplicable for pre-anesthetic assessment of airway in patients with no prior history of tracheal intubation. STUDY OBJECTIVES The purpose of the study was to compare and correlate the ultrasound view of the airway and the Cormack Lehane class...
full textUsefulness of Ultrasound View of Larynx in Pre-Anesthetic Airway Assessment: A Comparison With Cormack-Lehane Classification During Direct Laryngoscopy
BACKGROUND One of the main challenges in anesthesiology is difficult intubation. There are many anatomical parameters for evaluating the feasibility of tracheal intubation; one that can reliably predict a difficult intubation is the Cormack-Lehane classification obtained during direct laryngoscopy. This is an invasive procedure that cannot be performed in an awake patient or for pre-anesthetic ...
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D-blade is a relatively new device in the field of videolaryngoscopy, designed for airway management by enabling indirectoscopic glottic view. In our study, we investigated efficiency of D-blade in comparison with direct Macintosh laryngoscope (gold standard). Fifty-two adult patients with normal airway scheduled for elective surgery in general anesthesia were randomly assigned in D-blade video...
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full textMallampati class, obesity, and a novel airway trajectory measurement to predict difficult laryngoscopy.
OBJECTIVES/HYPOTHESIS To determine whether Mallampati class correlates with Cormack-Lehane grade in obese adults, and investigate a novel airway trajectory measurement (ATM) to anticipate difficult laryngoscopy. STUDY DESIGN Retrospective cohort plus a pilot study. METHODS One hundred eighty-four nonobese and 160 obese adults underwent laryngoscopy. Spearman correlations, gamma coefficients...
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Journal title
volume 65 issue None
pages 26- 30
publication date 2007-12
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