Comparison of different Head Positions on Awake Fiber Optic Intubatio

Objective: to compare the time required to perform awake fiber optic intubation with two different head positions: conventional sniffing position and head-up ramp position in patients with difficult airways who are planning to undergo thyroid surgery. Study Design: Quasi-experimental study Place and Duration of Study: Combined Military Hospital (CMH) Quetta and Combined Military Hospital (CMH) Multan, Pakistan from Oct 2022 to Nov 2023. Methodology: We performed our study on 36 patients with enlarged goiter and difficult airways by allocating them to two separate groups, S and R. Group-S patients underwent awake fiber optic bronchoscopy in the sniffing position, and Group-R underwent awake fiber optic intubation in the up-ramp position. The time was recorded to perform a successful awake-fiber optic laryngoscopy and use the jaw thrust maneuver. Results: The mean time taken for successful awake fiber optic intubation in Group-R was considerably less than in Group-S, with a p-value of <0.001. The mean time taken in Group-R was 20.00±3.773 minutes, and that in Group-S was 36.28±4.29 minutes. Conclusion: We concluded that the up ramp position was superior to the sniffing position for awake fiber optic intubation in patients with difficult airway