Comparison of the Upper Lip Bite Test with Inter Incisor Distance for prediction of difficult endotracheal intubation: A Prospective Single Blind Study

Dr. Veena Kachhwah; Dr. Neeraj Narang

Volume : VIII, Issue : X, October - 2018

Comparison of the Upper Lip Bite Test with Inter Incisor Distance for prediction of difficult endotracheal intubation: A Prospective Single Blind Study

Dr. Veena Kachhwah, Dr. Neeraj Narang

Abstract :

Background:

We prospectively compared the Upper Lip Bite Test with Inter Incisor Distance to predict difficult endotracheal intubation.

Method:

Two anaesthesiologist, not involved in intubation of airway of the patients, evaluated airway by using upper lip bite test (ULBT) and inter incisor distance (IID). Laryngoscopy and intubation performed by another anaesthesiologist, he assessed the laryngeal view and graded according to the Cormack–Lehane grading system. Sensitivity, specificity, accuracy, positive value, negative predictive value, internal consistancy were calculated for each test.

Results:

Upper Lip Bite Test is proved to be more sensitive in difficult intubation prediction (54.3%) in comparison to Inter Incisor Distance (9.6%). However Upper Lip Bite Test is found to be less specific (45.6%) to rule out easy intubations than Inter Incisor Distance (95.1%)

Conclusion:

We found that ULBT is more sensitive to anticipate difficult intubation than the IID. Nevertheless IID is more specific to predict easy intubations than the ULBT. Hence we feel that it would be better if we use IID first to rule out easy intubations as it is more specific than we can apply ULBT to the patients who’s airway is predicted as difficult by the IID, to predict true cases of difficult airway.