Gudivada KK, et al. - This prospective crossover study focused on the possible differences in the impact of the gold standard sniffing position (SP) versus further head elevation (HE) (neck flexion) on the incidence of difficult laryngoscopy, intubation difficulty, and variables of the Intubation Difficulty Scale (IDS) in adult patients undergoing elective surgery under general anesthesia. Findings demonstrated that IDS-assessed ease of intubation was superior in the HE position than in standard SP.

Methods

• This study evaluated the glottic view in SP compared to further HE by 1.5 inches during direct laryngoscopy in elective surgeries.
• Researchers randomly assigned patients to either Group A (“SP” during first laryngoscopy and “HE” during second laryngoscopy) or vice versa in Group B.
• They used a quantitative scale - The intubation difficulty scale (IDS) to assess the impact of patient position on ease of intubation.

Results

• Findings demonstrated that there were significant differences with regard to glottic visualization (P = 0.00), number of operators (P = 0.001), laryngeal pressure (P = 0.00), and lifting force (P = 0.00) required for intubation and IDS (P = 0.00), thus favoring further HE position.