Comparison of Laryngoscopic View Obtained by Conventional 10 cm Head Rise to that Obtained by Horizontal Alignment of External Auditory Meatus and Sternal Notch
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2019, Vol 6, Issue 4
Abstract
Objectives: The aim of this study was to determine the effect of position (Sniff / HELP) during laryngoscopy on the extent of change/ improvement in laryngoscopic view of glottis. Materials and Methods: This prospective, observational study was conducted on 245 patients who were scheduled to undergo elective surgeries, age 18-60 years, of either sex and ASA physical status I and II. Patients were positioned in HELP at first, following standard anaesthesia induction laryngoscopy was done to evaluate CL grade (HELP score). Patients were then positioned to sniff position and CL grade was reassessed (SNIFF score) and intubated. SNIFF score and HELP score were then compared. Chi-square, Fisher's exact, Student's t-test were used for analysis. Results: In 163 cases (66.5%) HELP and Sniff showed equal CL grades. In 67 cases (27.34%) HELP showed improved CL grades in comparison to Sniff. 47 cases (19.2%) of CL grade II by SNIFF position showed grade I view in HELP. Out of total 22 cases (9%) showing C & L grade III in SNIFF position, 15 cases (6.1%) showed grade I and 5 cases (2%) showed grade II in HELP. HELP provided equal/improved view in 230 cases (93.8%) of our study population which was statistically significant. Conclusion: HELP provides better glottic visualization and it should be the ideal intubating position for all patients (both obese and non obese) irrespective of age and sex. Neck circumference serves as more accurate predictor of poor glottic visualization during direct laryngoscopy as compared to BMI.
Authors and Affiliations
Aditi Goyal
Keywords
Related Articles
- EP ID EP622133
- DOI 10.21088/ijaa.2349.8471.6419.5
- Views 90
- Downloads 0
A Comparative Study of 0.5% Levobupivacaine with Dexmedetomidine 50 MCG and 0.5% Levobupivacaine Plain in Supraclavicular Brachial Plexus Block
Context: Several adjuncts are added to local anaesthetic agents to prolong the duration of regional blockade. In this study, we added dexmedetomidine to levobupivacaine for supraclavicular brachial plexus blocks. Aim: To...
Study on Oral Nebivolol in Attenuating the Cardio Vascular Responses to Laryngoscopy and Endotracheal Intubation
Introduction: Laryngoscopy and intubation are almost always associated with hemodynamic changes due to sympathetic discharge caused by epipharyngeal and laryngopharyngeal stimulation. Aim: To study the efficacy of oral N...
A Comparative Study on Safety of Combined Spinal and Epidural Anesthesia verses Epidural Anesthesia for Orthopedic and Gynecological Surgery
Background: In major surgeries, anesthesia plan requires modification as per patient’s need for safe outcome. Orthopedic and gynecological surgeries require excellent surgical conditions and prolonged and effective posto...
Melatonin Alprazolam Combination: Evaluation for Hemodynamic Stability during Intubation and Post Operative Analgesia in Patients Undergoing Cholecystectomy
Background: Many drugs have been used for attenuating hemodynamic response to intubation and laryngoscopy during general anesthesia, to provide post operative analgesia and to decrease the analgesic consumption in post o...
Comparison of 0.5% Bupivacaine and Dexamethasone with 0.75% Ropivacaine and Dexamethasone in Peribulbar Block for Small Incision Cataract Surgery: A Prospective Randomized Study
Objective: To compare the anaesthetic efficacy and postoperative analgesia of 0.75% ropivacaine and 2mg dexamethasone with 0.5% bupivacaine and 2mg dexamethasone in peribulbar block for patients undergoing small incision...