EVALUATION OF INTUBATING CONDITIONS DURING DIRECT LARYNGOSCOPY USING SNIFFING POSITION AND SIMPLE HEAD EXTENSION

Introduction: Tracheal intubation remains one of the commonest means of establishing an airway and the ability to maintain a good glottic visualization during direct laryngoscopy is the major determinant of ease of intubation. Sniffing position and simple head extension are the two positions used in direct laryngoscopy done for tracheal intubation in patients requiring general anaesthesia.

Aims and Objectives:1)To evaluate and compare glottic visualization using sniffing position and simple head extension during direct laryngoscopy.2)To evaluate and compare ease of intubation using sniffing position and simple head extension during direct laryngoscopy .3)To compare sympathetic response in sniffing position and simple head extension during direct laryngoscopy.

Material and Methods: The study will be conducted in Department of Anaesthesiology, GGS Medical College, Faridkot. Inclusion Criteria:1.Age group between 20-50 years. 2. ASA Grade I and II.3. Patients scheduled to undergo surgery under general anaesthesia. Exclusion Criteria: 1. Patients with body mass index more than 30 kg/m²2.Restricted neck movements.3.Bucked teeth 4.Thyromental distance less than 65mm. 5.Limitation of anterior and posterior movement of mandible. Written informed consent will be obtained from each patient. 220 patients scheduled for elective surgeries under general anaesthesia at department of anaesthesia, GGSMCH, Faridkot will be randomly assigned to one of two groups. In Group I patients, laryngoscopy will be done in sniffing position and in Group II patients, laryngoscopy will be done in simple head extension. Glottic visualization will be assessed by Modified Cormack and Lehane classification and ease of tracheal intubation will be assessed by Intubation Difficulty Scale. Also laryngoscopic sympathetic response will be assessed by means of heart rate and mean arterial blood pressure.