Comparison of Intubation Difficulty in Patients with and Without Obstructive Sleep Apnoea Syndrome

Abstract

BACKGROUND/AIMS: Obstructive sleep apnoea syndrome (OSAS) is a medical disease in which the upper respiratory tract is repeatedly blocked during sleep. Difficult intubation is more common among OSAS patients compared to the average population. Airway safety is also of importance for anaesthesia management. The prediction of difficult intubation may prevent many complications which can develop when attempting to establish the patency of the airway. MATERIAL AND METHODS: Patients who were going to undergo ear-nose-throat operations were allocated into two groups, including 209 patients without OSAS (Group 1) and 113 patients with OSAS (Group 2). The neck circumference, the inter-incisor distance, the sterno-mental (SM) and the thyro-mental (TM) distances were measured; the Mallampati (MP) and the Cormack-Lehane (CL) tests were performed and recorded. It was evaluated whether these tests could be used as predictive markers for difficult intubation or not. RESULTS: A neck circumference of above 40 cm, an inter-incisor distance lower than 4 cm, and MP and CL grades of 3 or 4 were found to be associated with difficult intubation. No association was found between difficult intubation and TM or SM. The rate of intubation difficulty was higher in the OSAS group. CONCLUSION: We found that a short inter-incisor distance, a large neck circumference and a high Mallampati and CL degree were related to difficult intubation and OSAS. In line with these results, we concluded that OSAS is associated with intubation difficulty. We consider that pre- specifying these tests could reduce airway-related complication risks.