Abstract：
UNASSIGNED: Difficult airway management is one of the main challenges in paediatric anaesthesia, particularly in low- and middle-income countries.
UNASSIGNED: The aim of this study was to investigate the main predictors of difficult paediatric intubation.
UNASSIGNED: In this observational study, we included all children aged less than five years undergoing intra-abdominal surgery with endotracheal intubation. Patients were divided into two groups according to the incidence of difficult intubation. Then, we investigated predictors for difficult paediatric intubation.
UNASSIGNED: We included 217 children, and difficult intubation was observed in 10% of them. Predictors were as follows: Mallampati III-IV class (adjusted odds ratio = 2.21; 95% confidence interval = 1.1-6.4), limited mouth opening (adjusted odds ratio = 2.4; 95% confidence interval = 1.8-3.5), facial dysmorphia (adjusted odds ratio = 2.6; 95% confidence interval = 1.32-7.4) and anaesthesia without muscle relaxant (adjusted odds ratio = 1.8; 95% confidence interval = 1.0-5.1) or without opioids during crash inductions (adjusted odds ratio = 1.7; 95% confidence interval = 1.01-4.8).
UNASSIGNED: Facial dysmorphia and limited mouth opening were predictors of difficult intubation in children. Furthermore, it seems that Mallampati class and anaesthesia technique may also predict challenging intubation, which may guide us to change our perioperative practice.
UNASSIGNED: The aim of this study was to investigate the main predictors of difficult paediatric intubation.
UNASSIGNED: In this observational study, we included all children aged less than five years undergoing intra-abdominal surgery with endotracheal intubation. Patients were divided into two groups according to the incidence of difficult intubation. Then, we investigated predictors for difficult paediatric intubation.
UNASSIGNED: We included 217 children, and difficult intubation was observed in 10% of them. Predictors were as follows: Mallampati III-IV class (adjusted odds ratio = 2.21; 95% confidence interval = 1.1-6.4), limited mouth opening (adjusted odds ratio = 2.4; 95% confidence interval = 1.8-3.5), facial dysmorphia (adjusted odds ratio = 2.6; 95% confidence interval = 1.32-7.4) and anaesthesia without muscle relaxant (adjusted odds ratio = 1.8; 95% confidence interval = 1.0-5.1) or without opioids during crash inductions (adjusted odds ratio = 1.7; 95% confidence interval = 1.01-4.8).
UNASSIGNED: Facial dysmorphia and limited mouth opening were predictors of difficult intubation in children. Furthermore, it seems that Mallampati class and anaesthesia technique may also predict challenging intubation, which may guide us to change our perioperative practice.
摘要：
■困难的气道管理是儿科麻醉的主要挑战之一，特别是在低收入和中等收入国家。
■本研究的目的是探讨儿科插管困难的主要预测因素。
■在这项观察性研究中，我们纳入了所有5岁以下接受气管插管的腹内手术的儿童.根据插管困难的发生率将患者分为两组。然后，我们调查了儿科困难插管的预测因素.
■我们包括217个孩子，在其中10％的患者中观察到困难的插管。预测因素如下：MallampatiIII-IV级（调整后的比值比=2.21；95％置信区间=1.1-6.4），张口受限(调整后的赔率比=2.4；95%置信区间=1.8-3.5)，面部畸形(调整后的比值比=2.6;95%置信区间=1.32-7.4)和无肌肉松弛剂麻醉(调整后的比值比=1.8;95%置信区间=1.0-5.1)或无阿片类药物麻醉(调整后的比值比=1.7;95%置信区间=1.01-4.8).
■面部畸形和张口受限是儿童插管困难的预测因素。此外，Mallampati类和麻醉技术似乎也可以预测具有挑战性的插管，这可能会指导我们改变围手术期的做法。
■本研究的目的是探讨儿科插管困难的主要预测因素。
■在这项观察性研究中，我们纳入了所有5岁以下接受气管插管的腹内手术的儿童.根据插管困难的发生率将患者分为两组。然后，我们调查了儿科困难插管的预测因素.
■我们包括217个孩子，在其中10％的患者中观察到困难的插管。预测因素如下：MallampatiIII-IV级（调整后的比值比=2.21；95％置信区间=1.1-6.4），张口受限(调整后的赔率比=2.4；95%置信区间=1.8-3.5)，面部畸形(调整后的比值比=2.6;95%置信区间=1.32-7.4)和无肌肉松弛剂麻醉(调整后的比值比=1.8;95%置信区间=1.0-5.1)或无阿片类药物麻醉(调整后的比值比=1.7;95%置信区间=1.01-4.8).
■面部畸形和张口受限是儿童插管困难的预测因素。此外，Mallampati类和麻醉技术似乎也可以预测具有挑战性的插管，这可能会指导我们改变围手术期的做法。
