Comparison of two different head positions for successful insertion of supraglottic airway device in adult patients undergoing elective surgery under general anaesthesia

This prospective, randomized study aims to compare the success of supraglottic airway device (SAD) insertion in two different head positions [without elevation (Group X) and with 5 cm head elevation (Group Y)] in adult patients undergoing elective surgery under general anaesthesia. Following Institutional Ethics Committee approval and written informed consent, 90 patients will be enrolled. Preoperative assessment will include airway evaluation using Mallampati score and mouth opening. Standard ASA monitoring will be applied, and patients will be premedicated with midazolam and fentanyl, followed by induction with propofol and muscle relaxation using vecuronium.

Patients will be randomized into two groups based on head positioning. A properly sized SAD will be inserted using the introducer technique with the neck in extension, and cuff inflation will be standardized at 60 cm H2O. The success of insertion will be confirmed using fibreoptic bronchoscopy and Brimacombe scoring. Time to successful insertion will be recorded until the first square EtCO2 waveform. Failure on first attempt will result in exclusion from the study, and airway management will proceed with endotracheal intubatio