Abstract
Head positioning is an important factor for successful endotracheal intubation during general anesthesia. The sniffing position, i.e. lower cervical flexion and atlanto-occipital extension, has been regarded as the ideal position for direct laryngoscopy. In this study, the sniffing and neutral head positions were compared for the laryngoscopic view using Cormack–Lehane (CL) grading system.
This comparative study was a randomized study at POF Hospital, Wah Cantt from March to July 2026. The patients were randomly divided into two groups: Sniffing Position (Group A, n=55) and Neutral Position (Group B, n=55) of general anesthesia. Demographic data and airway parameters such as age, gender, BMI, ASA classification, Mallampati classification and neck mobility were noted. The data were analyzed using SPSS version 25, Chi-square test, and Independent Samples t-test.
There were no differences in baseline characteristics between the groups (p > 0.05). The sniffing position group (60.0%) had more Grade I laryngoscopic view than the neutral position group (10.9%). The sniffing group had a higher proportion of patients with favorable laryngoscopic views (92.7% vs. 67.3% in the neutral group). The neutral group had more poor views (32.7% vs. 7.3%). The difference was highly significant (χ² = 31.113, p 0.001). The sniffing position should be used when performing a direct laryngoscopy because it offers the best laryngoscopic views