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A comparison of the upper lip bite test and modified mallampati classification in detecting difficult endotracheal intubation among surgical patients.


Ma. Graciela G. Lazatin,
Fatima Marie  P. Palad

Related Institution

Department of Anesthesiology - St. Luke's Medical Center

Publication Information

Publication Type
Publication Sub Type
Journal Article, Original
Philippine Journal of Anesthesiology
Publication Date
July-December 2004


Difficult tracheal intubation can be a major source of morbidity and mortality in clinical practice and unanticipated difficult intubation remains to be a primary concern of the anesthesiologist. Due to the potentially serious consequences of failed tracheal intubation, considerable attention has been focused on attempts to predict patients in whom laryngoscopy and intubation will be difficult. Although several tests have been made, the results are not totally reliable Methodology: One hundred ten patients, aged 16 years old and above, scheduled for elective surgery were enrolled in the study. They were assessed according to oropharyngeal class using the Modified Mallampati Classification (MMC) and the new Upper Lip Bite Test (ULBT). A quantitative seven parameter scale was used to determine difticult endotracheal intubation. Intubation Difficulty Scale (IDS) score of more than 5 (5) was assigned as moderate to major endotracheal difficulty while IDS score of less than or equal to 5 (/-5) as mild to no endotracheal difticulty. The incidence of difficult intubation among the subjects was 22.7 percent, as exhibited by IDS score of 5 Results: The results show that new ULBT technique has a higher sensitivity and negative predictive values than MMC, which suggests that ULBT may be used to screen for patients with difticult intubation. On the other hand, there is also an indication that those patients having both high MMC and ULBT scores are the ones who are more likely to have higher IDS scores. (Author)


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