https://doi.org/10.4081/ejtm.2022.10780

Comparing laryngeal view in neutral and sniff position during video laryngoscopy-guided intubation

Vol. 33 No. 1 (2023)
Submitted: 5 August 2022
Accepted: 8 August 2022
Published: 16 September 2022
Intubation, head position, laryngoscopy
Abstract Views: 752
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Authors

Uranus Khordad
Surgical and Trauma Research Center, AJA University of Medical Science, Tehran, Iran, Islamic Republic of.
Mohamad Reza Rafiei
Surgical and Trauma Research Center, AJA University of Medical Science, Tehran, Iran, Islamic Republic of.
Mehrshad Namazi
Surgical and Trauma Research Center, AJA University of Medical Science, Tehran, Iran, Islamic Republic of.
Arian Moayer
Surgical and Trauma Research Center, AJA University of Medical Science, Tehran, Iran, Islamic Republic of.
Mohammad Afsahi
Afsahi_m@yahoo.com
Surgical and Trauma Research Center, AJA University of Medical Science, Tehran, Iran, Islamic Republic of.

Appropriate positioning of the head is a crucial step for a successful intubation. Laryngoscopy is a commonly used method to facilitate the intubation process. This study evaluated the quality of intubation and its difficulty in sniff and neutral position. This was a clinical randomized trial, conducted in 2021 in Aja university of medical sciences. 40 patients, meeting the inclusion criteria were randomly assigned to sniff and neutral group and were intubated with standard procedure. The required time, number of attempts, laryngeal view, cord status, and the need for maneuver were evaluated between the two positions. Overall, 60 patients were intubated in sniff and 60 in neutral position. 51 of them were male and 69 were female. The mean intubation time was (17/15 ± 8/00) and (16/65 ± 8/66) seconds in neutral and sniff position, respectively (p-value = 0.181). There was no statistically significant difference in the required time. Additionally, 45 patients were intubated in first attempt and 15 were intubated after the second attempt in each group. There was no difference in any difficulty-related parameter of the two groups. No significant difference between the required time, attempt, or any other parameter was detected between the sniff and neutral groups. Evidence suggests that there is no superiority regarding these two positions and the decision should be made by the physician on a case-by-case basis.

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Google Scholar
Europe PMC
Petrini F, Accorsi A, Adrario E, Agrò F, Amicucci G, Antonelli M, Azzeri F, Baroncini S, Bettelli G, Cafaggi C, Cattano D, Chinelli E, Corbanese U, Corso R, Della Puppa A, Di Filippo A, Facco E, Favaro R, Favero R, Frova G, Giunta F, Giurati G, Giusti F, Guarino A, Iannuzzi E, Ivani G, Mazzon D, Menarini M, Merli G, Mondello E, Muttini S, Nardi G, Pigna A, Pittoni G, Ripamonti D, Rosa G, Rosi R, Salvo I, Sarti A, Serafini G, Servadio G, Sgandurra A, Sorbello M, Tana F, Tufano R, Vesconi S, Villani A, Zauli M; Gruppo di Studio SIAARTI "Vie Aeree Difficili"; IRC e SARNePI; Task Force. Recommendations for airway control and difficult airway management. Minerva Anestesiol. 2005 Nov;71 (11):617-57. English, Italian.
Ollerton JE, Parr MJ, Harrison K, Hanrahan B, Sugrue M. Potential cervical spine injury and difficult airway management for emergency intubation of trauma adults in the emergency department--a systematic review. Emerg Med J. 2006 Jan;23 (1):3-11. DOI: https://doi.org/10.1136/emj.2004.020552
Levitan RM, Heitz JW, Sweeney M, Cooper RM. The complexities of tracheal intubation with direct laryngoscopy and alternative intubation devices. Ann Emerg Med. 2011 Mar;57(3):240-7. Epub 2010 Jul 31. DOI: https://doi.org/10.1016/j.annemergmed.2010.05.035
Le Guen M, Coppere Z, Dufour G, Ouattara J, Trichereau J, Fischler M. HELP-VDL: study protocol for a multicentre, open, randomised, controlled clinical trial comparing the use of the head-elevated laryngoscopy position and the use of a videolaryngoscope to facilitate orotracheal intubation in a patient population without predictable difficulty of intubation. BMJ Open. 2020 Jul 8;10 (7):e036570. DOI: https://doi.org/10.1136/bmjopen-2019-036570
Lewis SR, Butler AR, Parker J, Cook TM, Smith AF. Videolaryngoscopy versus direct laryngoscopy for adult patients requiring tracheal intubation. Cochrane Database Syst Rev. 2016 Nov 15;11 (11):CD011136. DOI: https://doi.org/10.1002/14651858.CD011136.pub2
Kory P, Guevarra K, Mathew JP, Hegde A, Mayo PH. The impact of video laryngoscopy use during urgent endotracheal intubation in the critically ill. Anesth Analg. 2013 Jul;117 (1):144-9. Epub 2013 May 17. DOI: https://doi.org/10.1213/ANE.0b013e3182917f2a
Sakles JC, Chiu S, Mosier J, Walker C, Stolz U. The importance of first pass success when performing orotracheal intubation in the emergency department. Acad Emerg Med. 2013 Jan;20(1):71-8. DOI: https://doi.org/10.1111/acem.12055
Mendonca C, Ungureanu N, Nowicka A, Kumar P. A randomised clinical trial comparing the 'sniffing' and neutral position using channelled (KingVision® ) and non-channelled (C-MAC® ) videolaryngoscopes. Anaesthesia. 2018 Jul;73(7):847-855. Epub 2018 Apr 16. Erratum in: Anaesthesia. 2019 Aug;74(8):1061. DOI: https://doi.org/10.1111/anae.14289
Park S, Lee HG, Choi JI, Lee S, Jang EA, Bae HB, Rhee J, Yang HC, Jeong S. Comparison of vocal cord view between neutral and sniffing position during orotracheal intubation using fiberoptic bronchoscope: a prospective, randomized cross over study. BMC Anesthesiol. 2019 Jan 5;19(1):3. DOI: https://doi.org/10.1186/s12871-018-0671-9
Sadooghi, F. Comparing the sniff pillow and simple extension positions in the quality of ventilation with mask and laryngoscopy view during orotracheal intubation [Residency dissertation, Isfahan University of Medical Sciences]. Isfahan University of Medical Sciences Repository. 2006.
Ghasemi, A. Comparing the sniffing and neutral (simple head extension) positions for the ease of intubation in patients receiving general anesthesia in Shariati Hospital, Tehran, Iran [Medicine Doctoral dissertation, Tehran University of Medical Sciences]. Tehran University of Medical Sciences Repository. 2019

How to Cite

Khordad, U., Rafiei, M. R., Namazi, M., Moayer, A., & Afsahi , M. . (2022). Comparing laryngeal view in neutral and sniff position during video laryngoscopy-guided intubation. European Journal of Translational Myology, 33(1). https://doi.org/10.4081/ejtm.2022.10780
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