MODIFIED MALLAMPATI CLASSIFICATION SCORE- A SIMPLE TOOL FOR PREDICTING TOLERANCE IN UNSEDATED OESOPHAGOGASTRODUODENOSCOPY
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 35
Abstract
BACKGROUND 40-47% of patients poorly tolerates esophagogastroduodenoscopy (EGD). Early identification of potentially intolerant patients improve procedural success and avoid patient discomfort. Modified Mallampati Classification (MMC) score is a simple scoring system used to predict difficult tracheal intubation and laryngoscope insertion. As EGD involves the same level of patient discomfort during introduction, MMC may predict EGD tolerance. MATERIALS AND METHODS 100 patients with dyspeptic symptoms and no alarm features attending our department were recruited for unsedated EGD between January and July 2012. All patients had good performance status and underlying anxiety disorder was excluded. Based on MMC, patients placed into 4 classes- I: Soft palate, fauces, pillars and uvula visible. II: Soft palate, fauces and uvula visible. III: Soft palate and base of uvula visible. IV: Soft palate not visible. They were divided into good view (class I and II) and poor view (class III and IV). EGD was performed by the same consultant and MMS status assessed by two independent trained personnel. All received 2 doses of topical pharyngeal spray containing 10% lidocaine hydrochloride. Outcome measurements were gag reflex, endoscopist’s assessment and patient feedback. RESULTS Of 100 patients, 52 were males. 58 in group A and 42 in group B. Gag reflex was present in 32.7% of good view group compared to 78.6% in poor view (p<0.001). From the endoscopist’s view, good tolerability observed in 72.4% of good view group compared to 21% in poor view (p<0.001). 74.1% patient reported satisfactory feedback in good view group compared to 19% in poor view group (p<0.001). CONCLUSION MMC is a good clinical indicator for predicting tolerance in unsedated EGD.
Authors and Affiliations
Abishek Sasidharan, Sandesh Kolassery
Keywords
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- EP ID EP218857
- DOI 10.18410/jebmh/2017/407
- Views 79
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