Evaluation of the relationship between the STOP-Bang score with oxygen reserve index and difficult airway: a prospective observational study

Jul 30, 2023Brazilian journal of anesthesiology (Elsevier)

How STOP-Bang Scores Relate to Oxygen Levels and Airway Difficulty During Breathing Tests

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Abstract

In the high-risk group for Obstructive Sleep Apnea, the highest Oxygen Reserve Index (ORi) value reached during preoxygenation was lower, and the time to reach this value was longer.

Preoperative peripheral oxygen saturation values were lower in the high-risk group compared to the low-risk group.
The highest ORi value achieved during preoxygenation was significantly reduced in patients at high risk for OSA.
ORi values at the end of mask ventilation and at the end of intubation were also lower in the high-risk group.
The time taken to reach the highest ORi value was significantly prolonged for high-risk patients.
These findings suggest that monitoring ORi may help assess oxygenation and manage airway difficulties in OSA patients.

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BACKGROUND: Patients diagnosed with Obstructive Sleep Apnea (OSA) syndrome have a tendency towards hypoventilation, hypoxia, and hypercarbia in the perioperative period. This study hypothesized that the Oxygen Reserve Index (ORi) could predict possible hypoxia and determine difficult airways in patients at risk for OSA, as determined by the STOP-Bang questionnaire.

METHODS: This prospective study included adult patients undergoing elective surgery under general anesthesia with endotracheal intubation, divided into two groups: low risk (0-2 points) and high risk (3-8 points) based on their STOP-Bang questionnaire results. The primary outcome measure was the highest ORi value reached during preoxygenation and the time to reach this value. Data were recorded at four time points: before preoxygenation (T1), end of preoxygenation (T2), end of mask ventilation (T3), and end of intubation (T4), as well as partial oxygen pressure values in T1, T2, and T4. The secondary outcome measures were the grading scale for mask ventilation, Cormack-Lehane score, tonsil dimensions, use of a stylet, and application of the burp maneuver during intubation.

RESULTS: In the high-risk group, preoperative peripheral oxygen saturation values, the highest ORi value reached in preoxygenation, and ORi values at T3 and T4 times were lower, and the time to reach the highest ORi value was longer (p < 0.05).

CONCLUSION: Using ORi in patients with OSA may be useful in evaluating oxygenation, and since difficult airway is more common, ORi monitoring will better manage possible hypoxic conditions.

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Evaluation of the relationship between the STOP-Bang score with oxygen reserve index and difficult airway: a prospective observational study

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