Perbandingan antara Uji Mallampati Modifikasi dan Mallampati Ekstensi Sebagai Prediktor Kesulitan Intubasi Endotrakeal di Rumah Sakit Dr. Hasan Sadikin Bandung
Abstract
Evaluasi potensi intubasi sulit preoperatif sangat penting. Metode standar untuk menilai potensi intubasi sulit adalah metode Mallampati Modifikasi. Metode Mallampati Ekstensi merupakan metode Mallampati Modifikasi dengan ekstensi titik kranioservikal sehingga derajat bukaan mulut lebih lebar dan saluran napas terlihat lebih baik. Tujuan penelitian ini adalah mengetahui ketepatan penilaian Mallampati Ekstensi dibanding dengan Mallampati Modifikasi sebagai prediktor dalam menilai kesulitan intubasi endotrakeal menggunakan laringoskop Macintosh langsung berdasar atas uji Cormack Lehane. Desain penelitian ini adalah observasional analitik dengan metode potong lintang dan uji diagnostik chi square. Hasil penelitian terhadap 382 subjek pada bulan September 2016 hingga bulan Desember 2016 di Rumah Sakit Dr. Hasan Sadikin Bandung didapatkan jenis kelamin perempuan 69,9% dengan median usia 42 tahun. Frekuensi nilai uji Mallampati Ekstensi lebih banyak pada kelas yang lebih rendah dan berbeda secara signifikan dibanding dengan uji Mallampati Modifikasi. Kesesuaian penilaian kelas uji Mallampati Ekstensi dengan Cormack Lehane terdapat pada 318 subjek. Simpulan, uji Mallampati Ekstensi lebih baik daripada uji Mallampati Modifikasi sebagai prediktor menilai kesulitan intubasi endotrakeal menggunakan laringoskop langsung.
Comparison between Modified Mallampati Test and Extended Mallampati Test as Predictor of Difficult Endotracheal Intubationat Dr. Hasan Sadikin Hospital Bandung
Preoperative evaluation of potentially difficult intubation is very important. The standard method for assessing potentially difficult intubation is the Modified Mallampati method. Extended Mallampati method is a Modified Mallampati method with cranioservical extension point that the degree of mouth opening is wider and airway becomes more visible. The purpose of this study was to determine the accuracy of the Extended Mallampati test compared to the Modified Mallampati test as predictors in assessing the difficulty of endotracheal intubation using direct Macintosh laryngoscope based on Cormack Lehane grading. This was a cross-sectional observational analytical study using chi square diagnostic test involving 382 subjects at Dr. Hasan Sadikin Bandung Hospital during the period of September 2016 to December 2016 with 69.9% women and median age of 42 years. The frequency of the Mallampati Extension test scores was higher in the lower classes, which was significantly different from the results of the Modified Mallampati test. Better appropriateness of the Mallampati Extension test result with Cormack Lehane grading was found in 318 subjects. In conclusion, the Extended Mallampati test is better than Modified Mallampati test when it is used as a predictor in assessing difficult endotracheal intubation using direct laryngoscopy (Cormack Lehane test).
Keywords
Full Text:
PDFReferences
Zuercher M, Ummenhofer W. Cardiac arrest during anesthesia. Curr Opin Crit Care. 2008;14(1):269–74 .
Ellis SJ, Newland MC, Simonson JA, Peters KR, Romberger DJ, Mercer DW, dkk. Anesthesia-related cardiac arrest. Anesthesiology. 2014;120(4):829–38.
Adamus M, Fritscherova S, Hrabalek L, Gabrhelik T, Zapletalova J, Janout V. Mallampati test as a predictor of laryngoscopic view. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2010;154(4):339–44.
Mashour GA, Sandberg W. Craniocervical extension improves the specificity and predictive value of the mallampati airway evaluation. Anesth Analg. 2006;99(4):1256–9.
Krage R, Rijn V, Groeningen DV, Loer SA, Schwarte LA, Schober P. Cormack-lehane classification revisited. Br J Anaesth. 2010;105(2):220–7.
Prakash S, Rapsang AG, Mahajan S, Bhattacharjee S, Singh R, Gogia AR. Comparative evaluation of the sniffing position with simple head extension for laryngoscopic view and intubation difficulty in adults undergoing elective surgery. Anesthesiol Res Pract. 2011;2011(1):1–6
Lee JH, Jung HC, Shim JH, Lee C. Comparison of the rate of succesful endotracheal intubation between the “sniffing” and “ramped” positions in patients with an expected difficult intubation. Korean J Anesthesiol. 2015;68(2):116–21.
Safavi M, Honarmand A, Amoushahi M. Prediction of difficult laryngoscopy: Extended mallampati score versus the MMT, ULBT and RHTMD. Adv Biomed Res. 2014;3(1):133–8.
Shiga T, Wajima Z, Inoue T, Sakamoto A. Predicting difficult intubation in apparently normal patients: a meta-analysis of bedside screening test performance. Anesthesiology. 2005;103(2):429–37.
Benumof JL. Management of the difficult adult airway with special emphasis on awake tracheal intubation. Anaesthesiology. 1991;75(6):1087–110.
Mashour GA, Kheterpal S, Vanaharam V, Shanks A, Wang LY, Sandberg WS, dkk. The extended mallampati score and a diagnosis of diabetes mellitus are predictors of difficult laryngoscopy in the morbidly obese. Anesth Analg. 2008;107(6):1919–25.
DOI: https://doi.org/10.15851/jap.v5n3.1168
Article Metrics
Abstract view : 3437 timesPDF - 3135 times
This Journal indexed by
JAP is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
View My Stats