Patient arrival in pre anesthetic room, identification of patient and demographic details obtained

The following preanesthetic evaluations are done,

 1. Any significant present/past medical or surgical history, any drug allergy history

        2. General physical examination

        3. Clinical tests in airway examination

        4. Ultrasonography measurement of skin to epiglottis distance

        Vital parameters like B.P., Pulse, SpO2, Temperature, Respiratory rate

 Routine investigations: Hb, TLC, DLC, Bleeding Time, Clotting Time, PT-INR, Fasting blood sugar, Serum urea, Serum creatinine, SGOT, SGPT, Serum Electrolytes, Chest X-Ray, ECG, 2D-ECHO, coronary artery angiography (if required)

Patient received in OT identified, consent, NBM checked, monitored with ECG, NABP, pulse oximetry and capnography

 Preoxygenation will be done with 100% oxygen for 3-5 minutes.

 Anesthesia will be induced with Injection Propofol 2mg /kg and Injection Rocuronium Bromide 0.8 mg/kg IV, ventilated with oxygen and isoflurane 1.5% for 3min.

 Direct laryngoscopy is done with appropriate Macintosh blade by an anesthesiologist with more than 2 years of experience (post qualification) Cormack Lehane (CL) laryngoscopic grade was noted, Position of tube will be checked by 5-point auscultation method & capnography.

Intubating anesthesiologist was not involved in preoperative airway evaluation (clinical tests and sonographic airway assessment

Anesthesia maintained with isoflurane, booster doses of rocuronium and fentanyl as needed.

Based on the preoperative airway findings, intubation is categorized as either easy or difficult, with the aim of determining which factor is the better predictor of airway difficulty.