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J Clin Anesth. 2014 Aug;26(5):360-7. doi: 10.1016/j.jclinane.2014.01.010. Epub 2014 Jul 28.

STOP-Bang and prediction of difficult airway in obese patients.

Author information

1
Department of Anesthesiology, Oakwood Health Care System, Dearborn, MI 48124, USA.
2
Department of Anesthesiology, The Detroit Medical Center, 4201 St. Antoine, Detroit, MI 48201, USA.
3
Department of Anesthesiology, The Detroit Medical Center, 4201 St. Antoine, Detroit, MI 48201, USA; Department of Anestheisology, Wayne State University School of Medicine, Detroit, MI 48201, USA. Electronic address: howang@med.wayne.edu.

Abstract

STUDY OBJECTIVE:

To determine if a high score (≥ 3) on the STOP-Bang screening questionnaire for obstructive sleep apnea (OSA) predicts whether obese patients are at high risk for OSA and increased risk of difficult airway.

DESIGN:

Prospective, questionnaire-based clinical assessment.

SETTING:

University-affiliated hospital.

PATIENTS:

127 ASA physical status 2 and 3 patients, who were scheduled for elective bariatric surgery.

INTERVENTIONS:

Patients were allocated to three groups. Group 1 patients had a previous history of OSA, Group 2 patients had no history of OSA but did have a high STOP-Bang score (≥ 3), and Group 3 patients had no history of OSA but did have a low STOP-Bang score (< 3). Groups 2 and 3 only were assessed using the STOP-Bang questionnaire. After induction and intubation of the patient, an anesthesiologist who was blinded to the three study group allocations completed an airway questionnaire on the three study groups.

MEASUREMENTS:

The frequency of difficult airway, difficult mask ventilation with or without muscle relaxation, poor visualization of the vocal cords, difficulty in blade insertion, and difficult intubation were compared.

MAIN RESULTS:

The group of patients with high STOP-Bang scores (Group 2) and those patients previously diagnosed with OSA (Group1) showed a higher risk for difficult airway than the patients with low STOP-Bang scores (Group 3; P < 0.001).

CONCLUSION:

The STOP-Bang score may be used as an effective predictor of difficult airway in obese patients. Obese surgical patients with unknown/undiagnosed OSA status should be evaluated using the STOP-Bang questionnaire score.

KEYWORDS:

Difficult airway management; Intratrcheal; Intubation; Mask ventilation; Obesity; STOP-Bang questionnaire

PMID:
25081584
DOI:
10.1016/j.jclinane.2014.01.010
[Indexed for MEDLINE]

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