Comparison of Tracheal Intubation using Video-laryngoscopy versus Video-laryngoscope assisted Flexible Tracheoscopy in patients with simulated Manual In-Line Stabilization - A Randomized Control Trial.

After obtaining informed consent, patients presenting for elective or emergency surgery under general anaesthesia requiring tracheal intubation will be included in the study. Pre-anaesthetic and complete airway assessment will be done before surgery. After  administering pre-medication and attaching standard ASA monitors, patients will be randomized into two groups - VLS and VLF. Anaesthesia will be induced using 2 mcg/Kg Fentanyl, 2 mg/Kg propofol and 0.1 mg/Kg vecuronium. Face mask ventilation will be done for three minutes after which the pillow placed under the patient’s head will be removed. The patient’s head will be stabilized using MILS manouvre applied by an assistant standing on  the left side of  patient’s head. In group VLS,  intubation will be performed using C-Mac Video-laryngoscope. In group VLF, C- MAC video-laryngoscope will be inserted into the patient’s oral cavity by the primary anaesthesiologist which will the be handed over to an assisting anaesthesiologist after obtaining glottic view. The primary anaesthesiologist will then intubate using the flexible Tracheoscope ( aScope, Ambu Inc.,) which has been railroded with the Endotracheal tube. Time Taken to Intubate ( TTI) will be the time taken from the insertion of video-laryngoscope into the oral cavity until the appearance of 3 square capnogram waveforms. An attempt at intubation will be defined as the attempt to insert the video-laryngoscope blade into the oral cavity. Failed intubation will be defined as failure to intubate within 2 attempts