Comparison of Modified Altemirs technique with Seldingers technique of submental intubation for airway management in patients undergoing Complex maxillofacial fractures fixation surgery A Randomised Interventional Comparative Trial

This study will be conducted at Mathura Das Mathur Hospital, Dr S N Medical College Jodhpur after seeking clearance from the institutional ethical committee and obtaining written informed consent from the patients. This study will be done on the patients admitted to MDM hospital who will undergo complex maxillofacial fracture fixation surgery.

To ensure inclusion in the study, each patient will be subjected to a detailed pre-anaesthetic evaluation based on detailed history from patient/attenders and thorough physical examination as well as preanaesthetic airway assessment (mouth opening, thyromental distance, Mallampati grade, dentition etc) will be done. Basic demographic data like name, age, sex, height, and body weight for will be recorded. Complete general physical examination, BMI check, investigations and ASA grading will be done. In all the patients, baseline investigations will be done to rule out any abnormalities. Coagulation profile, random blood sugar levels, tests for HIV, hepatitis B surface antigen and hepatitis C virus antigen infections, ECG and chest X-ray posterior-anterior view and associated co-morbidities will be done. The purpose and detailed procedure will be explained to the patients. Written informed consent will be taken from all the patients about the procedure. All patients will be kept nil by mouth as per standard guidelines before the scheduled time of surgery.

Method- Before attempting oral endotracheal intubation, the connector will be released from the tube with the aid of mosquito forceps in such a way that it can be easily removed and reattached in the following steps. After obtaining proper consent initially all the patients will undergo orotracheal intubation by standard direct laryngoscopy using a reinforced endotracheal tube, Sterile painting and draping of the face and the neck will be done. Submental intubation will be done by either modified Altemir’s or seldinger’s technique.