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

Abstract

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.