Correlation of Neck Circumference With Difficult Mask Ventilation and Difficult Laryngoscopy in Morbidly Obese Patients

Correlation of Neck Circumference With Difficult Mask Ventilation and Difficult Laryngoscopy in Morbidly Obese Turkish Patients: A Prospective Clinical Trial

The aim of this study is to determine the correlation of neck circumference with difficult mask ventilation and laryngoscopy in morbidly obese patients.

Study Overview

• Status: Completed
• Conditions: Morbid Obesity

Detailed Description

Patients' Mallampati score, upper lip bite test, neck mobility, teeth abnormalities were evaluated preoperatively. Mouth opening, sternomental and thyromental distances, neck circumference, thoracic circumference, breast circumference , belly circumference and hip circumference were measured preoperatively.

After anesthesia induciton with propofol and rocuronium, patients' mask ventilation difficulty was evaluated as defined below: V1- Ventilated by single anesthesist easily; V2- Ventilated by single anesthesist with oral airway; V3- Ventilated by two anesthesists; V4- Unable to mask ventilate. V3 and V4 was defined as difficult mask ventilation.

Laringoscopy was performed with MacIntosh laryngoscop and Cormack Lehane (CL) score was evaluated. CL score III and IV were defined as difficult laryngoscopy.

• Study Type: Observational
• Enrollment (Actual): 120

Contacts and Locations

Study Locations

• Turkey
  • Istanbul, Turkey, 34098
    • Istanbul University Cerrahpasa Medical Faculty

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients with body mass index (BMI) > = 40, applied for elective surgery.

Description

Inclusion Criteria:

• BMI >= 40
• American Society of Anesthesiologists (ASA) Physical Status I-III
• Patients applied for elective surgery

Exclusion Criteria:

• BMI < 40
• maxillofacial tumor or fracture
• mass at the neck
• mass in the thorax or mediastina
• scar at the neck area
• previous radiotherapy history to neck area
• history of cervical vertebra operations
• cervical vertebra structure abnormality

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Correlation of difficult laryngoscopy with neck circumference	Cormack Lehane scores III and IV were defined as difficult laryngoscopy.	Cormack Lehane score was assessed during laryngoscopy
Correlation of difficult mask ventilation with neck circumference	Patients' mask ventilation difficulty was evaluated as defined below: V1- Ventilated by single anesthesist easily; V2- Ventilated by single anesthesist with oral airway; V3- Ventilated by two anesthesists; V4- Unable to mask ventilate. V3 and V4 was defined as difficult mask ventilation.	Ventilation difficulty scale was assessed during mask ventilation

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Correlation of difficult laryngoscopy with modified mallampati score	Cormack Lehane scores III and IV were defined as difficult laryngoscopy.	Cormack Lehane score was assessed during laryngoscopy
Correlation of difficult mask ventilation with modified mallampati score	Patients' mask ventilation difficulty was evaluated as defined below: V1- Ventilated by single anesthesist easily; V2- Ventilated by single anesthesist with oral airway; V3- Ventilated by two anesthesists; V4- Unable to mask ventilate. V3 and V4 was defined as difficult mask ventilation.	Ventilation difficulty scale was assessed after during mask ventilation
Correlation of difficult laryngoscopy with neck movement	Cormack Lehane scores III and IV were defined as difficult laryngoscopy.	Cormack Lehane score was assessed during laryngoscopy
with neck movement	Patients' mask ventilation difficulty was evaluated as defined below: V1- Ventilated by single anesthesist easily; V2- Ventilated by single anesthesist with oral airway; V3- Ventilated by two anesthesists; V4- Unable to mask ventilate. V3 and V4 was defined as difficult mask ventilation.	Ventilation difficulty scale was assessed during mask ventilation
Correlation of difficult laryngoscopy with dentition	Cormack Lehane scores III and IV were defined as difficult laryngoscopy.	Cormack Lehane score was assessed during laryngoscopy
Correlation of difficult mask ventilation with dentition	Patients' mask ventilation difficulty was evaluated as defined below: V1- Ventilated by single anesthesist easily; V2- Ventilated by single anesthesist with oral airway; V3- Ventilated by two anesthesists; V4- Unable to mask ventilate. V3 and V4 was defined as difficult mask ventilation.	Ventilation difficulty scale was assessed during mask ventilation
Correlation of difficult laryngoscopy with upper lip bite test	Cormack Lehane scores III and IV were defined as difficult laryngoscopy	Cormack Lehane score was assessed during laryngoscopy
Correlation of difficult mask ventilation with upper lip bite test	Patients' mask ventilation difficulty was evaluated as defined below: V1- Ventilated by single anesthesist easily; V2- Ventilated by single anesthesist with oral airway; V3- Ventilated by two anesthesists; V4- Unable to mask ventilate. V3 and V4 was defined as difficult mask ventilation.	Ventilation difficulty scale was assessed during mask ventilation
Correlation of difficult laryngoscopy with mouth opening	Cormack Lehane scores III and IV were defined as difficult laryngoscopy	Cormack Lehane score was assessed during laryngoscopy
Correlation of difficult mask ventilation with mouth opening	Patients' mask ventilation difficulty was evaluated as defined below: V1- Ventilated by single anesthesist easily; V2- Ventilated by single anesthesist with oral airway; V3- Ventilated by two anesthesists; V4- Unable to mask ventilate. V3 and V4 was defined as difficult mask ventilation.	Ventilation difficulty scale was assessed during mask ventilation
Correlation of difficult laryngoscopy with sternomental distance	Cormack Lehane scores III and IV were defined as difficult laryngoscopy	Cormack Lehane score was assessed during laryngoscopy
Correlation of difficult mask ventilation with sternomental distance	Patients' mask ventilation difficulty was evaluated as defined below: V1- Ventilated by single anesthesist easily; V2- Ventilated by single anesthesist with oral airway; V3- Ventilated by two anesthesists; V4- Unable to mask ventilate. V3 and V4 was defined as difficult mask ventilation.	Ventilation difficulty scale was assessed during mask ventilation
Correlation of difficult laryngoscopy with breast circumference	Cormack Lehane scores III and IV were defined as difficult laryngoscopy	Cormack Lehane score was assessed during laryngoscopy
Correlation of difficult mask ventilation with breast circumference	Patients' mask ventilation difficulty was evaluated as defined below: V1- Ventilated by single anesthesist easily; V2- Ventilated by single anesthesist with oral airway; V3- Ventilated by two anesthesists; V4- Unable to mask ventilate. V3 and V4 was defined as difficult mask ventilation.	Ventilation difficulty scale was assessed during mask ventilation
Correlation of difficult laryngoscopy with thorax circumference	Cormack Lehane scores III and IV were defined as difficult laryngoscopy	Cormack Lehane score was assessed during laryngoscopy
Correlation of difficult mask ventilation with thorax circumference	Patients' mask ventilation difficulty was evaluated as defined below: V1- Ventilated by single anesthesist easily; V2- Ventilated by single anesthesist with oral airway; V3- Ventilated by two anesthesists; V4- Unable to mask ventilate. V3 and V4 was defined as difficult mask ventilation.	Ventilation difficulty scale was assessed during mask ventilation
Correlation of difficult laryngoscopy with waist circumference	Cormack Lehane scores III and IV were defined as difficult laryngoscopy	Cormack Lehane score was assessed during laryngoscopy
Correlation of difficult mask ventilation with waist circumference	Patients' mask ventilation difficulty was evaluated as defined below: V1- Ventilated by single anesthesist easily; V2- Ventilated by single anesthesist with oral airway; V3- Ventilated by two anesthesists; V4- Unable to mask ventilate. V3 and V4 was defined as difficult mask ventilation.	Ventilation difficulty scale was assessed during mask ventilation
Correlation of difficult laryngoscopy with hip circumference	Cormack Lehane scores III and IV were defined as difficult laryngoscopy	Cormack Lehane score was assessed during laryngoscopy
Correlation of difficult mask ventilation with hip circumference	Patients' mask ventilation difficulty was evaluated as defined below: V1- Ventilated by single anesthesist easily; V2- Ventilated by single anesthesist with oral airway; V3- Ventilated by two anesthesists; V4- Unable to mask ventilate. V3 and V4 was defined as difficult mask ventilation.	Ventilation difficulty scale was assessed during mask ventilation

Collaborators and Investigators

• Sponsor: Istanbul University
• Investigators: Study Director: Güniz Köksal, Professor, Istanbul University Cerrahpasa Medical Faculty

Publications and helpful links

General Publications

• Ozdilek A, Beyoglu CA, Erbabacan SE, Ekici B, Altindas F, Vehid S, Koksal GM. Correlation of Neck Circumference with Difficult Mask Ventilation and Difficult Laryngoscopy in Morbidly Obese Patients: an Observational Study. Obes Surg. 2018 Sep;28(9):2860-2867. doi: 10.1007/s11695-018-3263-3.

Study record dates

Study Major Dates

• Study Start: March 1, 2015
• Primary Completion (Actual): December 1, 2015
• Study Completion (Actual): December 1, 2015

Study Registration Dates

• First Submitted: August 20, 2015
• First Submitted That Met QC Criteria: October 26, 2015
• First Posted (Estimate): October 28, 2015

Study Record Updates

• Last Update Posted (Estimate): February 11, 2016
• Last Update Submitted That Met QC Criteria: February 10, 2016
• Last Verified: February 1, 2016

More Information

Terms related to this study

• Keywords: morbid obesity; neck circumference; difficult laryngoscopy; difficult mask ventilation
• Additional Relevant MeSH Terms: Overnutrition; Nutrition Disorders; Overweight; Body Weight; Obesity; Obesity, Morbid
• Other Study ID Numbers: 02-887/2

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED