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Revista Brasileira de Anestesiologia
Article . 2018 . Peer-reviewed
License: CC BY NC ND
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Revista Brasileira de Anestesiologia
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License: CC BY NC ND
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Dificuldade na laringoscopia e na intubação orotraqueal: estudo observacional

Authors: Andrade, Rebeca Gonelli Albanez da Cunha; Lima, Bruno Luís Soares; Lopes, Douglas Kaíque de Oliveira; Couceiro Filho, Roberto Oliveira; Lima, Luciana Cavalcanti; Couceiro, Tania Cursino de Menezes;

Dificuldade na laringoscopia e na intubação orotraqueal: estudo observacional

Abstract

Resumo Introducao As complicacoes anestesicas associadas as vias aereas dificeis inesperadas por serem potencialmente catastroficas devem ser evitadas. O teste de Mallampati modificado e a manobra de protrusao mandibular possibilitam a identificacao da via aerea dificil. O objetivo deste estudo foi associar o teste de Mallampati modificado e a manobra de protrusao mandibular com a laringoscopia (Cormack‐Lehane) e tentar identificar um melhor preditor de via aerea dificil na populacao adulta submetida a cirurgia eletiva. Metodo Estudo corte transversal, foram analisados 133 pacientes adultos submetidos a cirurgias eletivas que necessitavam de intubacao orotraqueal. Avaliaram‐se a acuracia e especificidade do teste de Mallampati modificado e da manobra de protrusao mandibular, correlacionados com laringoscopia dificil (Cormack‐Lehane Graus 3 e 4). Resultados Entre os 133 pacientes avaliados, a taxa de intubacao dificil encontrada foi 0,8%, houve associacao entre os dois testes preditores propostos ( p = 0,012). Foram encontrados os seguintes valores para a especificidade 94,5% e a acuracia 95,4% na manobra de protrusao mandibular. Ja para o teste de Mallampati modificado valores de 81,1% e de 81,2% respectivamente. A analise de concordância Kappa identificou entre manobra de protrusao mandibular e Cormarck‐Lehane um resultado de 0,240; considerado razoavel. Por outro lado, observou‐se uma fraca (κ = 0,06) concordância entre o teste de Mallampati modificado e o Cormarck‐Lehane. Conclusao A manobra de protrusao mandibular apresentou acuracia e concordância superiores ao teste de Mallampati modificado, mostrou a capacidade de identificar uma via aerea dificil . Faz‐se necessario enfatizar a associacao dos testes na avaliacao do paciente, destacar a complementariedade deles, minimizar as consequencias negativas de laringoscopias repetidas.

Country
Brazil
Keywords

Airway, Laryngoscopy, 150, Difficult airway, Jaw‐thrust maneuver, Mallampati test, Intubation

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    influence
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
7
Top 10%
Average
Average
Green
gold