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Prospective Analytic Study of Airway Problems in Elective Vs Emergency Cases with a Difficult Airway

Narra Gopal Reddy* , Narra Gopal Reddy* , B. Raja Shekar Reddy** , T. Haresh*** , G. Vasavi***

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Indian Journal of Anesthesia and Analgesia 4(2):p 263-269, April - June 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4217.15

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Abstract

Background: A difficult airway is not only a problem during intubation but also equally a problem post­operatively in controlling the airway and if reintubation is required. A limited research study reports are available on this subject. Aim: This present study was aimed to evaluate peri­operative airway problems (ventilation and intubation, post­operative extubation and reintubation) in elective and emergency surgical cases with the difficult airway. Materials and Methods: This prospective study was conducted in teaching institute on 145 anticipated and unanticipated difficult intubation cases from January 2016 to December 2016. Both emergency and elective cases were included. The demographic data, problems of difficult ventilation, difficult intubation as well as post– operative ventilation and reintubation data were collected. The data compared, the outcomes and results between these two groups were analyzed by Microsoft excel­SSSA by ANOVA and student t­test. Results: There is no statistical difference demographic data. In difficult airway cases frequency of Ventilation and intubation problems were more in emergency cases. Ventilation problems in elective/ emergency problems were 13.79%/ 18.62% and intubation problems in elective/emergency were 23.45%/30.34% respectively. Extubation problems also occurred more in emergency cases (elective/ emergency was 5.52%+8.28%)/(8.97% +11.02% respectively). Reintubation problems were more in emergency cases (2.76%) as compared to elective cases (2.07%). Conclusion: Intubation and Extubation of the difficult airway is more problematic. Adequate preparation planning and perform the action. Only awake extubation has to be done in these patients. High­risk patients should be identified early and after following safety guidelines, the difficult airway problems should be tackled.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4217.15

Keywords

Difficult Airway; Ventilation; Intubation; Extubation; Peri­Operative Period; Re­Intubation.

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