Effect of head-elevated versus neutral position on tracheal intubation using a hyper-angulated video laryngoscope under cervical spine immobilization: a randomised crossover trial
Primary result · Intubation timeResult — go to the resultDifference −4.5 s 95% CI −7.5 to −1.8Authors' conclusion
The HE position significantly improved intubation efficiency and technical ease using a hyper-angulated videolaryngoscope under MILS.
Study context
- Population
- Adults undergoing elective surgery, intubated with a hyper-angulated videolaryngoscope (GlideScope®) under manual in-line stabilisation (MILS)intubation attempted in 177
- Participants
- 180 adults
- Comparison
- Head-elevated (HE) vs head-neutral (HN)
Primary result
Intubation time
Difference
−4.5 s
95% CI −7.5 to −1.8
P = 0.001
By group
HE vs HN
difference −4.5 s (95% CI −7.5 to −1.8); P = 0.001
As reported in the abstract
Further findings
Optimisation manoeuvres for blade insertion
P = 0.0001
Optimisation manoeuvres for TT advancement
P < 0.001
Easy modified Cormack-Lehane grades
P < 0.0001
Percentage of glottic opening score
P < 0.0001
| Outcome | HE | HN | P value |
|---|---|---|---|
| Modified intubation difficulty scale | 1 (IQR 0–1) | 2 (IQR 1–3) | P < 0.001 |
Intubation success
- Success in 177 patients in whom intubation was attempted
- 100%
Original publication
Effect of head-elevated versus neutral position on tracheal intubation using a hyper-angulated video laryngoscope under cervical spine immobilization: a randomised crossover trial. Anaesth Crit Care Pain Med. Published 3 December 2025. doi:10.
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