Predicting Difficult Intubation in Bariatric Surgery: Comparison of El Ganzouri Risk Index and Airway Ultrasound

NCT07316179 | Recruiting

• 1 other identifier: 10/9
• Study Type: observational
• Target: 52
• Locations: 1 country
• Sites: 1

Brief Summary

This study is designed as a prospective observational study and will be conducted at the Health Sciences University Antalya Training and Research Hospital. Adult patients scheduled to undergo bariatric surgery will be included. The aim of this study is to compare the El Ganzouri Risk Index (EGRI) and airway ultrasonography (USG) parameters in predicting difficult intubation and to evaluate their relationship with the Cormack-Lehane (CL) score obtained during direct laryngoscopy. Before surgery, each participant will be evaluated using both the EGRI scoring system and airway USG. During general anesthesia, tracheal intubation will be performed using direct laryngoscopy, and data including the CL score, intubation time, number of attempts, and the need for videolaryngoscopy will be recorded based on the anesthesiologist's observations. The collected data will be analyzed by classifying participants according to the presence or absence of difficult intubation, and statistical comparisons will be performed between EGRI scores and airway ultrasonography parameters. The results of this study may contribute to improved preoperative airway assessment and enhanced patient safety in bariatric surgery.

Conditions

Obesity & Overweight; Obesity Difficult Airway Airway Management; Obesity (Disorder); Difficult Airway; Difficult Intubation in Obesity; Difficult Laryngoscopy

Keywords

El Ganzouri Risk Index; Difficult airway; Obesity; Airway Ultrasonography; Airway Management

Outcome Measures

Primary Outcomes (1)

• Association between each individual ultrasound parameter and difficult laryngoscopy

  Difficult laryngoscopy will be defined as CL grades III-IV, which will serve as the reference standard. Each predefined airway ultrasonography parameter will be analyzed independently to evaluate its association with difficult laryngoscopy. No composite score will be calculated. The following preoperative airway ultrasonography measurements will be assessed individually: Tongue base thickness Hyomental distance in the neutral position Hyomental distance in the extended position Hyomental ratio (extension/neutral) Skin-to-hyoid distance Skin-to-epiglottis distance Skin-to-vocal cords (anterior commissure) distance Skin-to-cricoid cartilage distance Pre-epiglottic space depth Unit of Measure Centimeters (cm) for all linear measurements

  Baseline (preoperative period)

Secondary Outcomes (5)

• Comparison of Diagnostic Performance Between the EGRI and Airway USG Measurements

  Baseline (preoperative period)

• Association Between Airway Ultrasonography Parameters and Intubation Performance

  Perioperative period (during tracheal intubation)

• Predictive Performance of the EGRI for Difficult Laryngoscopy

  Baseline (preoperative period)

• Association Between Early Intraoperative Hemodynamic Instability and Difficult Laryngoscopy

  Perioperative period (first 30 minutes of surgery)

• Incidence and Clinical Correlates of Difficult Laryngoscopy in Obese Adults Undergoing Bariatric Surgery

  Perioperative period (during tracheal intubation)

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population will consist of adult participants aged 18 to 65 years with ASA physical status II or III who are scheduled to undergo elective bariatric surgery under general anesthesia. Eligible participants must provide written informed consent prior to inclusion in the study. Participants with upper airway anatomical pathology, previous tracheal or thyroid surgery, head or neck masses, history of radiotherapy to the head and neck region, cervical spine anomalies, or those unwilling to participate will be excluded.

You may qualify if:

• Adult patients aged 18 to 65 years.
• ASA physical status classification II or III.
• Scheduled to undergo elective bariatric surgery under general anesthesia.
• Patients who voluntarily agree to participate in the study and sign the informed consent form.

You may not qualify if:

• Patients younger than 18 years or older than 65 years
• Presence of upper airway anatomical pathology
• History of tracheal or thyroid surgery.
• History of radiotherapy to the head and neck region.
• Cervical spine anomalies.
• Individuals unwilling to participate in the study.

Sponsors & Collaborators

• Antalya Training and Research Hospital: lead

Study Sites (1)

Antalya Training and Research Hospital

Antalya, Antalya, 07050, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Obesity; Overweight

Condition Hierarchy (Ancestors)

Overnutrition; Nutrition Disorders; Nutritional and Metabolic Diseases; Body Weight; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Mehmet Tercan

  University of Health Sciences Antalya Training and Research Hospital

  STUDY DIRECTOR

Central Study Contacts

Ece Ilayda Tekdemir

CONTACT

+905362905627; ilaydatekdemir@hotmail.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 20, 2025
• First Posted: January 5, 2026
• Study Start: December 25, 2025
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): July 28, 2026
• Last Updated: March 9, 2026

Record last verified: 2026-03

Locations

TU (1)