This prospective observational study aims to evaluate the relationship between preoperative ultrasonographic airway measurements and the Pediatric Difficult Airway Classification (PeDiAC) score in pediatric patients undergoing general anesthesia. The study will assess whether ultrasound-derived airway parameters are associated with difficult airway characteristics and PeDiAC scores.

Difficult airway management in pediatric patients remains a significant challenge for anesthesiologists and is associated with increased perioperative morbidity. Accurate preoperative identification of children at risk for difficult airway management is essential for improving patient safety and optimizing airway strategies.

Airway ultrasonography has emerged as a noninvasive and bedside imaging modality that allows detailed assessment of upper airway anatomy. Several ultrasonographic airway parameters have been investigated as potential predictors of difficult airway management in children. However, the predictive value of these measurements remains uncertain, and their relationship with standardized pediatric difficult airway assessment tools has not been fully established.

The Pediatric Difficult Airway Classification (PeDiAC) score is a recently developed tool designed to standardize the assessment of difficult airway characteristics in pediatric patients. Evaluating the association between ultrasonographic airway measurements and the PeDiAC score may improve preoperative airway assessment and facilitate the identification of children at increased risk of difficult airway management.

This prospective observational study aims to investigate the relationship between preoperative ultrasonographic airway measurements and the PeDiAC score in pediatric patients undergoing elective surgery under general anesthesia. Preoperative airway ultrasound measurements will be obtained and compared with PeDiAC scores recorded during airway management.

The primary objective is to evaluate the correlation between ultrasonographic airway measurements and the PeDiAC score. Secondary objectives include assessing the predictive value of ultrasonographic measurements for difficult airway management and identifying airway parameters associated with increased airway difficulty in pediatric patients.

Inclusion Criteria:

• Children aged 1-18 years.
• Patients scheduled for elective surgery.
• Patients undergoing endotracheal intubation under general anesthesia.
• American Society of Anesthesiologists (ASA) physical status I-III.

Exclusion Criteria:

• Known craniofacial anomalies.
• Congenital airway malformations.
• Restricted cervical mobility.
• Emergency surgical procedures.
• Patients with a tracheostomy.
• Inability to obtain parental or legal guardian consent.

The study population will consist of pediatric patients aged 1-18 years with American Society of Anesthesiologists (ASA) physical status I-III who are scheduled to undergo elective surgical procedures requiring endotracheal intubation under general anesthesia at a tertiary care hospital. Eligible patients whose parents or legal guardians provide written informed consent and who meet all inclusion criteria will be consecutively enrolled during the study period.

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.