The best method to predict easy intubation: a quasi-experimental pilot study

Abstract

Purpose: To facilitate evaluation of the airway before endotracheal intubation, different scores have been developed, mainly to predict difficult airways. However, in anesthesia clinical practice in Sweden, scores would be more useful if they could also predict an easy airway, so that the correct category of anesthesia personnel can be allocated. Therefore, we evaluated whether scoring systems commonly used to predict difficult airways could also predict easy endotracheal intubation.

Design: This prospective observational study included patients who were scheduled for general anesthesia and required endotracheal intubation.

Methods: Airways were evaluated preoperatively by two independent variables, namely Mallampati classification and thyromental distance. After anesthesia induction, the Cormack and Lehane grade was assessed.

Finding: Mallampati scores yielded the highest specificity in predicting easy intubation, and Cormack and Lehane grades yielded the highest positive predictive value for predicting easy intubation.

Conclusions: Mallampati classification is an appropriate screening test for predicting easy intubation.

Keywords: Cormack and Lehane grade; Mallampati classification; airway management; intubation.