Relación entre distancia pretraqueal y circunferencia del cuello como predictores de vía aérea difícil en pacientes con sobrepeso y obesidad, Hospital José Carrasco Arteaga. Cuenca, 2018

Abstract

INTRODUCTION: The prevalence of the obese population has increased in recent times and we know the incidence of difficult airway in obese people in increased up to three times compared to people with normal weight. In obese people, a neck circumference greater than 40 cm has been associated with a difficult intubation. Several studies have relied on ultrasound to predict difficult intubation. OBJECTIVE: To determine if there is a relationship between pre-tracheal distance and cervical circumference as predictors of difficult airway in patients who are overweight and obese. METHODS: An observational, cross-sectional and analytical study was carried out. The universe was made up of all overweight and obese patient undergoing elective surgery under general anesthesia. The sample was 182 patient of both sexes with BMI > 25 undergoing elective surgery under general anesthesia at the José Carrasco Arteaga Hospital, who in the preoperative period were measured cervical circumference and pre-tracheal distance by ultrasound, subsequently orotracheal intubation was performed by laryngoscopy to determine the existence of a difficult airway with the Cormack scale. A confidence level of 95%, margin of error of 5%, probability of occurrence of 13.8 % was used. The data were obtained from the medical record using the respective form and analyzed with the SPSS 22.0 program, free version. RESULTS: In this study the incidence of difficult airway was 14.8% in overweight and obese patients; 22.9% in the cervical girth group of ≥ 40 cm; 92.3% in the pre-tracheal distance group of ≥ 72.7% in patients of morbid obesity group (BMI ≥ 40). The results indicate that at a measure of pre-tracheal fat ≥ 28mm, and cervical circumference ≥ 40 cm, increase the difficulty in intubation, a statistical test was performed using Xi2 which concludes that the association is statistically significant for both variables with p 0.000.