Comparison of Tracheal Intubation in Ramp vs Sniffing Position Using Customized vs Fixed Pillow

NCT07506655 | Enrolling By Invitation DMC

• 1 other identifier: IRB-000178/SMBBIT/Approval/25
• Study Type: interventional
• Target: 2
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to find out whether the ramp position or sniffing position is better for endo tracheal intubation which provides better hemodynamic stability and short intubation time and good laryngoscopic view in regards of cormack lehane grading.

Conditions

Elective Surgery; General Anesthesia

Keywords

Airway management; Sniffing position; Ramp position; Tracheal intubation; Pillow height

Outcome Measures

Primary Outcomes (1)

• First-Attempt Intubation Success Rate

  Percentage of patients in whom successful intubation is achieved on the first attempt using the study device.

  During the procedure

Secondary Outcomes (4)

• Heart Rate

  0, 3, and 5 minutes after intubation

• Intubation Time

  Measured during the procedure (from laryngoscope insertion to confirmation via end-tidal CO₂)

• Blood Pressure

  0, 3, and 5 minutes after intubation

• Cormack-Lehane Grade

  During laryngoscopy

Study Arms (2)

Group A - Fixed Pillow

EXPERIMENTAL

Participants receive a fixed pillow height of 4 cm to align the head for laryngoscopy.

Device: Group A - Fixed Pillow

Group B - Customized Pillow

EXPERIMENTAL

Participants receive a customized pillow height of 4-8 cm to align the external auditory meatus and sternal notch.

Device: Group B - Customized Pillow

Interventions

Group A - Fixed Pillow DEVICE

Fixed pillow height of 4 cm for laryngoscopy alignment

Group A - Fixed Pillow

Group B - Customized Pillow DEVICE

Pillow with adjustable height 4-8 cm to align external auditory meatus and sternal notch for laryngoscopy.

Group B - Customized Pillow

Eligibility Criteria

• Age: 18 Years - 60 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Age between 18 and 60 years
• ASA physical status I or II
• Mallampati class I or II
• Patients scheduled for elective surgery
• BMI between 25 and 30
• Either gender

You may not qualify if:

• ASA physical status III or IV
• Predicted difficult intubation (Mallampati class III or IV)
• Maxillofacial trauma, tumors, or obvious malformations of the neck or face
• Pregnancy
• Unstable cervical spine

Sponsors & Collaborators

• Shaheed Mohtarma Benazir Bhutto Institue of Trauma: lead

Study Sites (1)

Shaheed Mohtarma Benazir Bhutto

Karachi, Sindh, 74200, Pakistan

Location

Related Publications (1)

• Okada Y. Nakayama Y. Hashirnoto K, Koike K, Watanabe N. Ramped versus sniffing position ibr tracheal,/ intulrirtion: A systcrnatic revierv aod rncta-analysis, Ant J llmerg Mctl. 2021 ;44:250- 6.

  BACKGROUND

Related Links

• Ramped versus sniffing position for endo tracheal intubation

Study Officials

• Dr Zafar Mehdi, Fcps anaesthesiology

  Shaheed Mohtarma Benazir Bhutto Institue of Trauma

  STUDY DIRECTOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: DEVICE FEASIBILITY
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: Participants will be randomly assigned to one of two groups: Group A (fixed pillow height of 4 cm) or Group B (customized pillow height 4-8 cm to align the external auditory meatus and sternal notch). The study will compare laryngoscopy view and intubation time between the two groups. Randomization is computer-generated, and all patients will undergo a standardized anesthesia protocol. Outcome data, including Cormack-Lehane grade, intubation time, and hemodynamic parameters, will be recorded.

Study Record Dates

• First Submitted: February 26, 2026
• First Posted: April 2, 2026
• Study Start: January 1, 2026
• Primary Completion: May 1, 2026
• Study Completion: May 1, 2026
• Last Updated: April 28, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)