SNIFFING VERSUS RAMPED POSITION IN THE VIDEO-LARYNGOSCOPY-GUIDED TRACHEAL INTUBATION OF MORBIDLY OBESE PATIENTS: A PROSPECTIVE RANDOMIZED OBSERVATIONAL STUDY

Sniffing versus Ramped position in the videolaryngoscopy-guided tracheal intubation of morbidly obese patients: a prospective randomized observational study”

Introduction: Ramped positioning is recommended for intubating obese patients undergoing direct laryngoscopy. However, whether the use of the ramped position can provide any benefit in videolaryngoscopy-guided intubation remains unclear. This study assessed intubation time using videolaryngoscopy in morbidly obese patients in the ramped versus sniffing positions.

Materials and Methods: This is a prospective randomized observational study in patients with morbid obesity (n = 82 body mass index [BMI] ? 35 kg/m2). Patients were randomly allocated to either the ramped or the standard sniffing position groups. During the induction of general anesthesia, difficulty in mask ventilation was assessed using the Warters scale. Tracheal intubation was performed using a C-MAC® D-Blade videolaryngoscope, and intubation difficulty was assessed using the intubation difficulty scale (IDS). The primary endpoint was the total intubation time calculated as the sum of the laryngoscopy and tube insertion times.

Conclusion: Compared with the sniffing position, the ramped position reduced intubation time in morbidly obese patients and effectively facilitated both mask.