Background and Goal of Study: Difficult laryngoscopy and intubation in obesity patients is more
frequent than in patients with normal  BMI [1,2,3,4]. Adequate assessment of difficult airway before
surgery with general  anaesthesia is topical . The aim of our study was to audit predictive value of El ­
Ganzouri  scale for patients with BMI more than 30 kg/m2.
Materials and methods: Our department has accepted special  protocol  for patients with BMI more
than 30 kg/m2 since 2016. This protocol  includes assessment of airway by El ­Ganzouri  scale and
intubation by videolaryngoscope in all  cases. El ­Ganzouri  scale included 7 measures (mouth open,
thiromental  distance, Mallampati  class, neck mobility, the possibility of mandibule extension, body
weight, anamnesis of difficult intubation. If a patient gains from 0 till  3 poi nts, intubation could be
performed with standard laryngoscopy. If a patient gains from 4 till  7 points, intubation is
recommended with video laryngoscopy. If a patient gains 8 points or more, awake intubation is
recommended wi th bronchoscope. On the first step anaesthesiologysts try to intubate the patients
was using videolaryngoscope as standard laryngoscope. If it not possible anaesthesiologysts used
this dev ce as videolaryngoscope. We used STATISTICA 10.0 for data analysis.
Results and discussion: During our audit were assessed 50 patients (29 women and 21 men,
aged from 26 to 74) which were scheduled general  anaesthesia with tracheal  intubation. Median of
BMI ­ 37 kg/m2 (30,5-­71). 28 patients had from 0 till  3 points, 22 patients had from 4 till  7 points by
El ­Ganzouri  scale. Nobody had 8 points or more. Laryngoscopy and intubati on w th standard
laryngoscopy technique was performed in 39 cases. Laryngoscopy and intubati on with
videolaryngoscopy was performed in 11 cases. accordance with Griner P .F . at al . formula. Sensivity
was 81 %, specific ­ 66%, positive predictability­ 40%, negative predictability ­ 93% (Griner P .F . at
al . formula).
Conclusion(s): We recommend El ­Ganzouri  scale for airway assessment in obese patients. This
scale has high prognosis value for standard laryngoscopy. If El ­Ganzouri  scale recommends using
videolaryngoscope, it is better to use it even if intubation may be successful  with a standard
laryngoscope.
References: 1. A. De Jong at al . 2015, 2. Lundstrоm LH at al . 2009, 3. Rose DK at al . 1994, 4. Uribe
AA at al . 2015.

Audit of using El-Ganzouri prognosis scale for difficult airway assessment in obese patients