ASSESSMENT OF PATIENT POSITION FOR FIBEROPTIC INTUBATION USING VIDEOLARYNGOSCOPY

Study Objective: To compare laryngoscopic appearance obtained during f lexible fiberoptic laryngoscopy with the patient's atlanto-occipital j oint in the neutral and extended positions. Design: Controlled clinica l trial with each patient (in the neutral position) acting as his or h er own control. Setting: University teaching hospital. Patients: 20 ad ult ASA physical status I and II patients, without anatomical airway a bnormalities, undergoing elective surgical procedures. Interventions: Fiberoptic laryngoscopy was performed on each patient with his or her atlanto-occipital joint in the neutral and extended positions. Measure ments and Main Results: Photographs of the laryngoscopic appearances w ere graded on a scale of 1 to 4 by a blinded observer according to the proportion of the laryngeal inlet visible. Atlanto-occipital extensio n improved laryngoscopic appearance in 14 cases and produced no change in the remaining 6. Conclusion: Atlanto-occipital extension is a usef ul maneuver during attempted fiberoptic intubation.