ACROMIO-AXILLO-SUPRASTERNAL NOTCH INDEX [AASI] : A SCREENING METHOD TO PREDICT DIFFICULT LARYNGOSCOPY IN PATIENT UNDERGOING GENERAL ANAESTHESIA AND REQUIRING ENDOTRACHEAL INTUBATION

Introduction and Aims: Difficult laryngoscopy [poor visualisation of larynx] is a surrogate indicator difficult intubation inability to manage larynx (DVL) can be life threatening. This study performed assess the ability new index –Acromio -Axillo-Suprasternal Notch Index predict in patient undergoing general anaesthesia addition other common predictors. Material Methods: 100 patients with ASA class I II candidate for endotracheal were enrolled this study. The four usual tests Modified MallampatiTest[MMT], Ratio Of Height Thyromental Distance[RHTMD], Neck Circumference/ distance, Sternomental distance difference assessed before induction anaesthesia. test AASI calculated as follow: 1) Using ruler line drawn vertically from top acromion process superior border axilla at pectoralismajor muscle named A. 2) A second perpendicular suprasternal notch (line B) 3)That portion that lies above where B bisects C. length C divided by A[AASI = C/A]. By skilled anaesthesiologist more than 5 years experience & who was unaware study, done based on Cormack-Lehane classification, grading recorded. Sensitivity, specificity, positive predictive value negative 95% Confidence Interval each airway predictor isolation studied. Results: DVL observed 12% patients. We sensitivity,specificity,PPV,NPV,AUC Roc[95% confidence interval] 80%[44.4-97.5%], 95.56%[89-98.8%],66.67%[42.22-84.6%],97.7%[92.6-99.33%},0.985[0.898-0.988]respectively these results are better conventional methods Conclusion: or equal 0.5 good direct laryngoscopy.