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Comparison of ramped and sniffing positions in video-laryngoscopy-guided tracheal intubation for elective cesarean section: a prospective randomized study.
Muhammet Korkusuz, Tayfun EtDepartment of Anaesthesiology and Reanimation, Karamanoglu Mehmetbey University, School of Medicine, Karaman, TurkeyINTRODUCTION: The physiological and anatomic changes in pregnancy create a series of difficulties in intubation for general anesthesia. Therefore, the aim of this study was to investigate the effects on the duration of intubation of the ramped and sniffing positions in the videolaryngoscopy guidelines in the cesarean section.
METHODS: A total of 60 patients undergoing elective cesarean section with general anaesthesia were randomly separated into 2 groups. Both groups were intubated with videolaryngoscopy; one group in the sniffing position with a pillow 7cm in height placed below the occiput, and the other group in the ramped position with specially designed pillows providing horizontal alignment of the external auditory meatus and sternal notch. The intubation times were compared between the groups.
RESULTS: The total intubation time was determined to be statistically significantly shorter in the ramped position (11.80 ± 2.30 s) than in the sniffing position (14.06 ± 1.86 s) (p<0.001). The laryngoscopy time was significantly shorter in the ramped position group (5.61±1.22 s) than in the sniffing position group (7.37±1.48 s) (p<0.001), and the tube insertion time was similar in botth groups (p>0.117).
DISCUSSION AND CONCLUSION: To be able to prevent desaturation which can develop rapidly in rapid intubation because of the reduced functional residual capacity and increased oxygen consumption in pregnancy, the ramped position may be a better option than the sniffing position in pregnant patients applied with tracheal intubation with videolaryngoscopy in cesarean section surgery.
Manuscript Language: English