Work

Evaluation of the Acromio-Axillo-Suprasternal Notch Index as a Predictor of Difficult Laryngoscopy in Pediatric Patients: An Observational Study

Year: 2026

Type: article

Abstract: Background and Objective: Predicting difficult endotracheal intubation in the pediatric population remains a challenge for anesthesiologists as limited cooperation, unique anatomical conditions, congenital abnormalities, and lack of appropriately sized airway equipment pose additional challenges. Acromioaxillo suprasternal notch index (AASI) has emerged as a promising tool requiring minimal patient cooperation, making it suitable for pediatric use. The objective of the study is to evaluate the effectiveness of AASI in predicting difficult laryngoscopy in children aged 2–10 years undergoing general anesthesia with endotracheal intubation. Materials and Methods: The cross-sectional observational study was conducted in children ( N = 55) aged 2–10 years scheduled for surgery requiring general anesthesia. Preoperative measurements including age, weight, height, Cormack-Lehane grade, application of laryngeal pressure, the number of intubation attempts, and AASI scores, were recorded. The sensitivity, specificity, and overall accuracy of AASI in predicting difficult tracheal intubation were assessed. Results: The mean age of the children was 5.92 ± 2.88 years, with the majority being girls (70.91%). Increased AASI score, number of intubation attempts, and increased laryngeal pressure were significantly associated with difficult laryngoscopy. A moderate positive correlation was found between AASI and the Cormack-Lehane score ( r = 0.5313; P < 0.001). We observed that sensitivity, specificity, and area under curve the ROC curve for AASI (cutoff of >0.51) were 66.67%, 85.29%, and 0.7787 respectively. Logistic regression analysis revealed AASI as a significant predictor of difficult laryngoscopy ( P = 0.0026). Conclusion: AASI is a good predictor of difficult laryngoscopy in children aged 2-10 years. It can serve as a valuable preoperative screening tool for identifying high-risk patients.

Source: Journal of Pharmacy And Bioallied Sciences

DOI: 10.4103/jpbs.jpbs_1407_25

Authors: Purvashree Vijay Deshmukh, Rishabh G. Mankale, Vandana Abhijit Gogate

Institutions: Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research

Language: English

Topic: Airway Management and Intubation Techniques

Subfield: Anesthesiology and Pain Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $250