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ORIGINAL ARTICLE
Year : 2018  |  Volume : 15  |  Issue : 1  |  Page : 17-23

Use of the “L-E-M-O-N” score in predicting difficult intubation in Africans


1 Department of Anesthesia, University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria
2 Department of Anesthesia, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Kaduna State, Nigeria
3 Department of Anesthesia, University of Jos Teaching Hospital, Jos, Plateau State, Nigeria

Correspondence Address:
Elizabeth O Ogboli-Nwasor
Department of Anesthesia, Ahmadu Bello University Teaching Hospital Shika, Zaria, Kaduna State
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njbcs.njbcs_25_16

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Background: Endotracheal intubation is an integral part of airway management and is key to the practice of safe anesthesia. Prediction of a difficult airway can help reduce the incidence of failed or difficult intubation. We studied the use of “L-E-M-O-N” (Look-Evaluate-Mallampati-Obstruction-Neck mobility) scoring system to predict difficult intubation and determine the prevalence of difficult intubation among adult surgical patients. Materials and Methods: One hundred and sixty (160) consecutive ASA I–III surgical patients between 18 and 65 years of age were recruited from October to December 2011. A variety of airway tests using the “L-E-M-O-N” scoring were done during preoperative assessment; and at induction of anesthesia, airway assessment using Cormack and Lehane was performed and the results were recorded by a standardized record sheet. The variables evaluated were gender, age, weight, height, body mass index (BMI), dentition and a variety of airway tests using the “L-E-M-O-N” scale. SPSS version 17.0 was used for statistical analysis; and a P value <0.05 was considered significant. Results: Prevalence of difficult intubation using Cormack and Lehane score only was found to be 8.1%. The “LOOK” features had sensitivities of 99.1%, 96.6%, and 92.5% for facial trauma, large incisors, and beard or moustache, respectively, and positive predictive values of 0%. Combination of predictors in the “L-E-M-O-N” score showed that, as the mean “L-E-M-O-N” score of the patients increased, the likelihood of difficult visual laryngoscopy also increased. Conclusion: Combination of airway predictors in the “L-E-M-O-N” scoring system significantly improves the ability to predict difficult intubation.


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