DUA EDEN İŞARETİ VE AVUÇ İÇİ BASKISI TESTLERİNİN ZOR ENTUBASYON TANI TESTLERİYLE İLİŞKİSİ

Year 2020, , 201 - 205, 11.05.2020

Ümran Karaca , Gürayten Özyurt

https://doi.org/10.18229/kocatepetip.582644

Abstract

AMAÇ: Genel anestezi altında endotrakeal entübasyon gerektiren hastalarda dua eden işareti (DEİ) ve avuç içi baskısı (AİB) testlerinin görülme sıklığını belirleyip, zor entübasyon tanı yöntemleri olan ağız açıklığı, baş boyun ekstansiyonu, mandibulanın malpozisyonu, tiromental mesafe, modifiye Mallampati skoru (MMS), Cormack ve Lehane skoru (CLS) ile ilişkisini araştırmayı amaçladık.
GEREÇ VE YÖNTEM: Çalışmamız; elektif şartlarda, genel anestezi altında ameliyat olan ASA I-III 330 hastayı kapsadı. Anestezi polikliniğine başvuran hastaların demografik özellikleri, zor entübasyon hikayesi ve kronik hastalıkları kayıt edildi. Ayrıca baş ekstansiyon, mandibulanın malpozisyonu, ağız açıklığı ve tiromental mesafe ölçümleri; MMS, DEİ ve AİB testleri uygulandı. Hastalara en az iki yıl deneyimli anestezi doktoru tarafından entübasyon gerçekleştirildi. Kullanılan laringoskop ve bleyd türü, endotrakeal tüp, rehber tel, CLS, larinks maske, entübasyon larinks maske, fiberoptik entübasyon kullanımına, dışarıdan bası uygulama gerekliliği, zor entübasyon varlığı ve olası komplikasyonlar belirlendi. P<0.05 istatistiksel anlamlı kabul edildi.
BULGULAR: Çalışmamızda; zor entübasyon insidansı % 5.2 idi. DEİ pozitif ve Grade 2-3 AİB olan hastalarda zor entübasyon görülme sıklığı daha yüksekti (p<0.05). Dua Eden işareti pozitif hastalarda; MMS 3-4 ve CLS III-IV sıklığı düşük bulundu (p>0.05). Avuç Baskısı testinin; CLS ve MMS arasında anlamlı ilişki saptandı. (sırasıyla p=0.013, p=0.044 ). Zor entübasyon görülme duyarlılığı, her iki test de düşük bulundu (sırasıyla, %41 ve %10).
SONUÇ: Avuç İçi Baskı testi, MMS ve CLS ile gösterdiği anlamlı ilişki nedeniyle zor entübasyon tanısında yer alabilir.

Keywords

Zor entübasyon, Prayer Sign, Palm Print, diyabet, artrit

Supporting Institution

Uludağ Ünivesitesi Tıp Fakültesi

RELATIONHIPS BETWEEN PALM PRINT AND PRAYER SIGN TESTS WITH DIFFICULTCULT INTUBATION DIAGNOSIS TESTS

Abstract

OBJECTIVE: We aimed to compare the prayer sign (PS) and palm print (PP) tests for difficult intubation diagnostic tests including open mouth distance, movement of neck and mandibula, thyromental distance, modified Mallampati scores (MMS), and Cormack-Lehane scores (CLS) in patients who required endotracheal intubation for general anesthesia.
MATERIAL AND METHODS: Three hundred and thirty patients as ASA I-III status who required endotracheal intubation for general anesthesia were included in this study. Patient’s demographic datas and chronic diseases were recorded. Diagnostic tests including open mouth distance, movement of neck and mandibula, thyromental distance, MMS, PS and PP tests were performed to all patients and recorded. All patients were intubated by an anesthesiologist who has at least two year experience. The kind of laryngoscope and blade, CLS, the necessity of guide, laryngeal mask airway, intubation laryngeal mask airway, fiber optic intubation, and cricoid pressure, the incidence of the difficult intubation were recorded. P <0.05 was considered statistically significant.
RESULTS: In our study; the incidence of difficult intubation was 5.2%. Difficult intubation was found higher in patients included in palm print test 2-3 and with positive PS test (p<0.05). A significant relationship was determined between PP test with CLS and MMS (p=0.013, p=0.044,respectively ). The frequency of MMS 3-4 and CLS III-IV was low in patients with positive praying sign (p> 0.05).Sensitivity to difficult intubation was found to be low in both tests (41% and 10%, respectively).
CONCLUSIONS: According to our results, PP test can be used as diagnosis of difficult intubation due to its significant relationship with MMS and CLS tests.

Keywords

Difficult intubation, Prayer Sign, Palm Print, diabetes mellitus, artritis

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