Predicting difficult intubation in bariatric surgery using the El Ganzouri Risk Index and airway ultrasound

A Prospective Observational Study Comparing the El Ganzouri Risk Index and Airway Ultrasonography in Predicting Difficult Intubation in Patients Undergoing Bariatric Surgery

This project sees if the El Ganzouri Risk Index or airway ultrasound better predicts difficult intubation in adults having bariatric (weight-loss) surgery.

Quick facts

• Study type: Observational
• Enrollment: 52 (estimated)
• Ages: 18 Years to 65 Years
• Sex: All
• Sponsor: Antalya Training and Research Hospital (Government)
• Locations: 1 site (Antalya, Antalya)
• Trial ID: NCT07316179 on ClinicalTrials.gov

What this trial studies

This prospective observational comparison will enroll adults scheduled for elective bariatric surgery at Antalya Training and Research Hospital. Before anesthesia each participant will receive an El Ganzouri Risk Index (EGRI) assessment and airway ultrasonography; during induction direct laryngoscopy will be used for tracheal intubation while recording Cormack-Lehane grade, intubation time, number of attempts, and any need for videolaryngoscopy. Participants will be classified by presence or absence of difficult intubation and the predictive performance of EGRI and ultrasound parameters will be compared statistically. The study aims to clarify which preoperative measures best correlate with direct laryngoscopic view and identify predictors of difficult airway in obese patients.

Who should consider this trial

Good fit: Ideal candidates are adults aged 18–65 with ASA physical status II or III who are scheduled for elective bariatric surgery and can give informed consent.

Not a fit: Patients with upper airway anatomical pathology, prior tracheal or thyroid surgery, head/neck radiotherapy, cervical spine anomalies, or those outside the 18–65 age range would be excluded and not benefit from this protocol.

Why it matters

Potential benefit: If successful, this could help anesthesiologists identify patients at higher risk for difficult intubation before surgery, allowing better airway planning and potentially reducing complications.

How similar studies have performed: Prior studies show both clinical risk scores like the EGRI and airway ultrasound can predict difficult intubation with variable accuracy, and ultrasound has shown promising but not consistently definitive results.

Eligibility criteria

Inclusion Criteria:

* 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.

Exclusion Criteria:

* 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.

Where this trial is running

Antalya, Antalya

• Antalya Training and Research Hospital — Antalya, Antalya, Turkey (Türkiye) (Recruiting)

Study contacts

• Study coordinator: Ece Ilayda Tekdemir

Conditions Obesity & Overweight; Obesity Difficult Airway Airway Management; Obesity; Difficult Airway; Difficult Intubation in Obesity; Difficult Laryngoscopy; El Ganzouri Risk Index; Difficult airway