Does neck circumference help to predict difficult intubation in obstetric patients? A prospective observational study

Area of Science:

• Anesthesiology
• Obstetric Anesthesia
• Airway Management

Background:

• Failed intubation during obstetric procedures is a leading cause of anesthesia-related maternal mortality.
• Neck circumference has emerged as a potential predictor of difficult intubation, particularly in obese populations.

Purpose of the Study:

• To identify an optimal cutoff value for neck circumference in predicting difficult intubation specifically within the obstetric patient population.
• To evaluate the utility of various airway assessment parameters in obstetric patients.

Main Methods:

• Ninety-four parturients undergoing cesarean section under general anesthesia were enrolled.
• Preoperative measurements included neck circumference and standard airway assessments.
• Difficult intubation was defined using the Intubation Difficulty Scale (IDS) score (≥5).

Main Results:

• Neck circumference (P=0.011) and Mallampati score (P=0.005) were significant predictors of difficult intubation.
• Neck circumference ≥33.5 cm demonstrated 100% sensitivity and 50% specificity for predicting difficult intubation.
• Other airway parameters like thyromental distance were not significant predictors.

Conclusions:

• A neck circumference of 33.5 cm or greater serves as a sensitive predictor for difficult intubation in obstetric patients.
• This finding aids in preoperative risk assessment for airway management in this vulnerable group.