Evaluation of intubating conditions during direct laryngoscopy Using sniffing position and simple head extension

Aims and Objectives: Evaluate better glottic visualization and ease of intubation using sniffing
position and simple head extension during direct laryngoscopy.
Material and Method: The present study was conducted on 200 healthy adult patients of ASA grade
1 and II. of either sex, aged 20-50 years. scheduled for elective surgery under general anaesthesia
Patients were divided into two groups of 100 each:
GROUP I: Laryngoscopy was done in sniffing position.
GROUP II: Laryngoscopy was done in simple head extension.
Glottic visualization during, laryngoscopy was assessed using Cormack and Lehanc grading and
difficulty in intubation was assessed by using Intubation Difficulty Scale (IDS).
Results: The distribution of patients with different Cormack and Lehanc gradis between two
intubation positions were significantly different (p<0.05) which indicated that ldottic visualization
was much better in sniffine position (62%) as compared to simple head extension (40%). Total IDS.
score. Indicating the ease of tracheal intubation was significantly better (p<0.05) in group I as
compared to group II which suggested 'that intubation was easier when the patient's head was placed
in sniffing position in comparison to simple head extension.
Conclusion: Sniffing position is superior to simple head extension with regard to better glottic
visualization and ease of intubation during laryngoscopy and endotracheal intubation.