الفهرس | Only 14 pages are availabe for public view |
Abstract This study was designed to detect the possible difficulties which may occurred when anaesthetizing patients with OSAS including the incidence of difficult intubation. Also, there was a need to evaluate the validity of commonly used predictors for difficult intubation in these patients. We studied 15 patients diagnosed as OSAS and submitted for UPPP surgery. The exclusion criteria included chronic obstructive pulmonary diseases, hepatic or renal insufficiency and ischemic heart diseases. The studied patients were evaluated preoperatively for difficult intubation by 3 predictors namely: Mallampati test, Multivariate risk index and Indirect laryngoscopy, then we evaluated the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of these tests by comparing the outcome of their prediction and the proved state of laryngoscopy and intubation. The recorded perioperative data included: HR, MAP, Blood gasometric data and chest x-ray. Any complication was also recorded. The results of this study showed that OSAS is common in males than females and most of them were obese to morbidly obese. They were usually polcythemic and mild hypertensive. There were no significant changes in HR and MAP in the peri operative period. Arterial oxygen saturation was slightly low before surgery and showed evident improvement (0.05) 24 hr postoperatively. Also, pH value showed slight decrease 1 hr, G hr, 24 hr postoperatively, but still within the normal r~nge. Other gasometric values showed no significant changes. The majority of patients were assessed as Mallampai class 1 & 2 (86.6%), and (60%) were grade I & II when examined by Indirect laryngoscopy. 5 patients had a Multivariate risk index score of 4. Evaluation of laryngoscopy and intubation indicated that 7 patients (46.6 %) were easily intubated while 8 patients (53.3%) showed difficult intubation, one of them was tracheost01l1ized. |