Veena N, Vimal Pradeep
BACKGROUND Patients presenting for coronary artery bypass graft surgery can have higher incidence of difficult airway. Awareness about the incidence and predictors of difficult airway in CABG patients will help the anaesthesia provider in being adequately prepared for management of a difficult airway situation thereby reducing the laryngoscopy related adverse events on myocardial oxygenation. MATERIALS AND METHODS 100 consecutive patients scheduled for CABG under general anaesthesia were enrolled. Age, gender, weight, modified Mallampati class, neck extension, thyromental distance, diabetes mellitus and extent of coronary artery involvement determined by CAG were the study variables. Patients were classified as either having difficult laryngoscopy, or not, as the outcome variable. Associations between these were measured using appropriate statistical tests. RESULTS Analysis showed significant association between Mallampati class, number of coronary vessels involved, and diabetes mellitus. Mallampati class 3 or 4, triple vessel disease as evidenced by preoperative coronary angiogram and presence of diabetes mellitus were found to predict more chances of encountering difficult laryngoscopy. CONCLUSION 13% of patients posted for CABG had difficult laryngoscopy. Advanced age and obesity were not found to be of significance in our population of patients posted for CABG. Mallampati class, presence of diabetes mellitus and more extensive coronary vessel involvement where shown to predict more probability of difficult laryngoscopy in patients presenting for CABG.
