Comparison Between Incidence of Post Operative Sore Throat with Conventional Intubation and 180 Degree Rotation of Endotracheal Tube During Intubation in Adult Patient Under General Anaesthesia

GROUP C , patients intubated by conventional method of intubation.

GROUP R , patients intubated by 180 degree rotation of endotracheal tube during intubation.

After shifting the patient to the operating room, patient will be placed in supine position and

standard monitors will be attached including heart rate , electrocardiogram , non

invasive blood pressure monitor and pulse oximetry. Pre-oxygenation will be done

with 100 percent Oxygen for 3 minutes. Induction will be done with inj. midazolam 1mg, inj.

propofol 2 mg per kg , inj. fentanyl 2 mcg per kg, inj. vecuronium 0.1mg per kg intravenously.

Appropriate size of endotracheal tube will be chosen according to the age of the patient.

Patient will be placed in the supine position with the head in sniffing position to facilitate

optimal alignment of the oral pharyngeal and laryngeal axis. After achieving adequate depth of anaesthesia and ensuring jaw relaxation, the endotracheal tube inserted using MacIntosh

laryngoscope by conventional method and 180 degree clockwise rotation of endotracheal

tube when tip of endotracheal tube just enters in glottis. Correct positioning will be confirmed

by observing bilateral chest movement, five point auscultation of breath sounds and the

presence of a square wave capnography. The patient will be ventilated using oxygen plus nitrous

oxide or Air plus sevoflurane until MAC 0.8 to 1.2 is achieved. Further course of anaesthesia will

proceed as per standard protocols keeping in mind need of the patient,  and surgery.

At the end of the surgery, neuromuscular blockade will be reversed using intravenous

neostigmine 0.05mg per kg and glycopyrrolate 0.01mg per kg. After confirming adequate reversal of

neuromuscular blockade and return of spontaneous respiration, the endotracheal tube will be

removed once the patient is awake, obeying verbal commands and able to maintain a patent

airway. The patient will be then shifted to the post op recovery room. In cases where

endotracheal tube removal is not performed due to clinical or surgical reasons, the patient

will be excluded from the study to maintain consistency in outcome assessment.