The Development of a Headrest for Intubation in Patients Under General Anesthesia

Abstract

Background: Optimal head positioning is crucial for successful endotracheal intubation under general anesthesia. This study assessed the efficacy of a Modified Pillow designed to improve airway alignment and intubation conditions compared to a standard pillow, focusing on laryngoscopic view, ease of intubation, and user satisfaction. Materials and methods: A total of 320 patients undergoing surgery with general anesthesia were randomly assigned to either the Regular Pillow group or the Modified Pillow group. Patients were aged 18 years or older, classified as ASA I-II, and without cervical spine injuries. Airway assessments included Mallampati classification, thyromental distance, mouth opening, and laryngoscopic view. The BURP (backward, upward, rightward pressure) maneuver was employed during intubation attempts. User satisfaction was also evaluated. Statistical analyses (t-tests, Chi-square tests, and logistic regression) compared both groups. Results: Demographics and baseline airway characteristics were similar across groups, except for mouth opening, which was significantly better in the Modified Pillow group (P = 0.001). The Modified Pillow reduced the need for the BURP maneuver (P = 0.036) and achieved higher user satisfaction scores (P < 0.001). No significant differences were noted in laryngoscopic grades or the number of intubation attempts. The ergonomic design and comfort of the Modified Pillow were highlighted as key advantages by anesthesia providers. Conclusion: The modified pillow offers significant benefits in head positioning for intubation, reducing reliance on the BURP maneuver, and improving user satisfaction. While both pillows provided effective airway management, the ergonomic advantages of the Modified Pillow enhance its value in clinical anesthesia practice.