British Journal of Anaesthesia, Vol 77, Issue 3 312-316, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia
SAL. Ramadhani, L. A. Mohamed, D. A. Rocke and E. Gouws
Sternomental distance and view at laryngoscopy were documented in 523
parturients undergoing elective or emergency Caesarean section under
general anaesthesia. Eighteen (3.5%) had a grade III or IV laryngoscopic
view (Cormack and Lehane's classification) and were classified as
potentially difficult tracheal intubations. There was a significant
difference between sternomental distance in those patients with a grade III
or IV laryngoscopic view compared with those with a grade I or II (13.17
(SD 1.54) cm vs 14.3 (1.49) cm; P = 0.0013). A sternomental distance of
13.5 cm or less with the head fully extended on the neck and the mouth
closed provided, using discriminant analysis, the best cut-off point for
predicting subsequent difficult laryngoscopy. A sternomental distance of
13.5 cm or less had a sensitivity, specificity, positive and negative
predictive values of 66.7%, 71.1%, 7.6% and 98.4%, respectively. While
there was no association between sternomental distance and age, weight,
height or body mass index (BMI), there was a significant association
between grade of laryngoscopy (III and IV) and older (P = 0.049) and
heavier (P = 0.0495) mothers. The results suggest that while sternomental
distance on its own may not be an adequate sole predictor of subsequent
difficult laryngoscopy the measurement should be incorporated into a series
of quick and simple preoperative tests.
CLINICAL INVESTIGATIONS
Sternomental distance as the sole predictor of difficult laryngoscopy in obstetric anaesthesia
Department of Anaesthesia, A1 Corniche Hospital, Abu Dhabi, United Arab Emirates; Department of Anaesthesia, University of Natal, Durban, South Africa; Institute of Biostatistics, Medical Research Council, Durban, South Africa
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