Anesthesia and Pain Medicine (Oct 2023)

The sniffing position facilitated easier light wand guided endotracheal intubation compared with the neutral position with chin-lift

  • Gunn Hee Kim,
  • Eun Jae Jung,
  • Yun Jae Han,
  • Mi Jung Yun

DOI
https://doi.org/10.17085/apm.23079
Journal volume & issue
Vol. 18, no. 4
pp. 431 – 438

Abstract

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Background Traditionally, the patient's head is placed in a neutral position with a chin-lift to facilitate light wand guided endotracheal intubation. However, our study found that the sniffing position was more effective. In this study, we aimed to compare the two positions of light wand guided endotracheal intubation. Methods Sixty adult patients were included in the study, after obtaining informed consent, and were randomly assigned to one of two groups: a control group in a neutral position with a chin-lift (group C, n = 30) and a sniffing position group (group S, n = 30). In group C, the anesthesiologist inserted a light wand after lifting the patient's mandible using the thumb of their non-dominant hand inside the patient's mouth. In group S, a light wand was inserted after the patient's head was flexed with the neck extended. We assessed variables such as light-search time, number of intubation attempts, time to achieve intubation, and side effects including blood tinge on the endotracheal tube, hoarseness, sore throat, and anesthesiologist satisfaction. Results The light-search and intubation times were shorter in group S than in group C. The incidence of blood tinge on the endotracheal tube was higher in group C than in group S. Anesthesiologist satisfaction was higher in group S than in group C. Conclusions The sniffing position was more effective in facilitating light wand guided endotracheal intubation than the neutral position with a chin-lift.

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