A Comparative Study of Glottic Visualisation and ease of intubation between sniffing position and 25 degree backup position in adult patients undergoing General Anaesthesia

After obtaining approval and clearance from the institutional ethics committee,  the patients fulfilling the inclusion criteria will be enrolled for the study, after  obtaining informed consent will be included in the study and divided  into two groups using computer generated randomization sequence.

1.Group I = Sniffing position

2.Group II = 25â—¦ backup position

All patients evaluated thoroughly in preoperative period for Mallampati grading, thyromental distance, Inter-incisor gap, Neck movements, Mandibular movement,  Pharyngeal pathology. All patients kept nil per oral overnight and premedicated with  alprazolam 0.5mg the previous night of surgery. After arriving at pre operative room  IV line secured and fluids connected. In operation theater Non-invasive blood pressure, Plethysmography, Electrocardiography connected. Before induction in Group  I (sniffing position) patients 8cm head ring placed under head in supine position. All  patients will be premedicated, preoxygenated, induced as per institutional protocol. At  time of Direct laryngoscopy using size 3 Macintosh blade, in Group I patients head  will be extended at atlanto-occipital joint maximally, in Group II patients 25-degree backup position will be given at torso at level of hip. Glottic visualization during  laryngoscopy assessed by Cormack and Lehane grading and Ease of intubation will be assessed by Intubation Difficulty Scale (IDS)