Background & Objective: With the extensive use of the laryngeal mask airway (LMA) for anesthesia ... more Background & Objective: With the extensive use of the laryngeal mask airway (LMA) for anesthesia as well as in emergency airway management, learning alternative techniques of insertion is essential for the safe and quick use of the device in some cases. The smooth and quick insertion of LMA leads without repeated attempts reduce the consequent complications. We compared standard technique with 180° rotation with inflated cuff technique for LMA Classic insertion. Methodology: This study was done in Basrah University Medical Center from 1st January 2019 to 31st December 2019. During this period, in 397 patients LMA was used for general anesthesia. Out of these, in 197 patients we used 180° rotation technique of insertion of LMA with fully inflated cuff and in 200 patients the standard method was used as a control group. The patients’ ages ranged between 15 and 45 y, and they were scheduled to undergo short surgical procedures and to require general anesthesia. Results: Three hundred a...
Objective: The best laryngeal view can be obtained when external laryngeal manipulation is undert... more Objective: The best laryngeal view can be obtained when external laryngeal manipulation is undertaken by the anesthesiologist to improve glottis visualization and enhance endotracheal intubation. This study aimed to evaluate the effectiveness of using anesthesiologist own left little finger to optimize laryngeal view during endotracheal intubation in small children. Methods: The study was conducted in Basra Teaching Hospital over a period from February 2013 to October 2013. Children below 5 years, ASA class I undergoing
Monitoring of patients in the recovery room is considered the most serious part for safe anesthes... more Monitoring of patients in the recovery room is considered the most serious part for safe anesthesia. Anesthesiologists are some times so busy in completing the list of the operations so they can not follow up thoroughly their discharged patient from the theatre. This study determines the most common recovery room incidents in the last three years at AlSadir Teaching Hospital in Basrah. Of the about 7000 patients operated upon in this period, 669 patients (9.5%) had some event in the recovery room. The most common incident was respiratory problems (26%), irritability (22%), thermal (19%), cardiovascular (18%), nausea and vomiting (9%), low urine output (5%) and fall from couch (1%). Most of these incidents were treated immediately at the recovery room. The outcome was 5 deaths and 61 ICU admissions. Skilled anesthesia assistant present in the recovery room is the keystone for taking care and reducing recovery room incidents.
Unpleasant drug incidents are common during medical action. In anesthetic practice, the probabili... more Unpleasant drug incidents are common during medical action. In anesthetic practice, the probability of errors is greater because of more tension and rapidity. Morbidity and even mortality are more expected in the course of anesthesia. Apart from many hazards that patients are exposed to such as; Biological hazards, Mechanical hazards, Chemical hazards, Physical hazards, and Personal Hazards 1 , it seems that danger of drug problems are more. The factors that make drug harm to a patient undergoing surgery through general anesthesia includes 2 , 3 .
ifficult intubation occurs relatively commonly in association with general anaesthesia. Its true ... more ifficult intubation occurs relatively commonly in association with general anaesthesia. Its true incidence is unknown but is estimated to be 1-3%. Approximately half of all cases are not predicted 1. A difficult intubation can be anticipated in a number of circumstances including a previous history of difficulty with intubation, syndromes known to be associated with difficulty to intubate, and some pathoanatomical states involving the head and neck region. Less reliable are anatomical characteristics which may be sought at preoperative assessment including interincisor distance 2 , Palm print 3 and prayer's signs 4 , head extension degree, thyromental distance 5 and the relative tongue/pharyngeal size 6 (Mallampati test). Inter-incisor distance Inter-incisor distance with maximal mouth opening < 3 cm: difficult laryngoscopy < 2 cm: difficult LMA insertion Other ways to anticipate difficult intubation in diabetics and patients with rheumatoid arthritis are the palm print and prayer signs. Palm Print Test: The palm and fingers of the dominant hand of the patient is painted with black writing ink using a brush. The patient then press the hand firmly against a white sheet of paper on a hard surface. Scoring is done as: Grade 0: All phalangeal areas visible. Grade1: Deficiency in the inter-phalangeal areas of 4th and/or 5th digit. Grade2: Deficiency in the inter-phalangeal areas of 2nd to 5th digit. Grade 3:Only the tips of digits seen.
From the time when succinylcholine(scoline) introduced to clinical anesthesia, intravenous route ... more From the time when succinylcholine(scoline) introduced to clinical anesthesia, intravenous route of administration of the drug has been broadly practiced. Severe bradycardia and arrhythmias may from time to time produced by single or frequent doses. The mechanism of bradycardia caused by succinylcholine administration has not been completely explained, it has been found that succinylcholine produce a unpredictable effects on the sinoatrial node. In our hospital , a second dose of succinylcholine is usually used for short surgical procedures that required good relaxation like anorectal surgery and orthopedic manipulation under anesthesia. This study aimed to discuss the conditions under which bradycardia appear during general anesthesia with oxygen, propofol, scoline, halothane, along with the use of second dose of scoline and assess the need for atropine to prevent this effect. Fifty patients aged between 20-50 years of American Society of Anesthesiologists (ASA) class I were included in this study, anesthesia was induced with propofol, scoline, along with oxygen halothane mixture, then 2nd dose of scoline was given 10 minutes later. Frequent pulse rate were recorded. There was considerable decrease in pulse rate of the patients after the 2nd dose of succinylcholine, 36% of the patients developed bradycardia (pulse rate below 60), and the mean reduction in pulse rate was (23±13 beats/min). However there is no need for the use of atropine since all of the patients return to normal rates (60-100 beats/min) within 1 minute spontaneously. Conclusion: It has been found that the use of scoline in one dose produce decrease in pulse rate but not reach to the bradycardia level, while the uses of another dose will result in significant reduction in pulse rate that can reach to the level of bradycardia. All patients return to normal level of pulse rate within 1 minute, therefore, there is no need to use atropine neither preoperatively nor after developing of bradycardia since it's a self limiting phenomenon.
Background: In anesthesia practice, obstructing materials like thick mucus secretion, debris or b... more Background: In anesthesia practice, obstructing materials like thick mucus secretion, debris or blood clots, and food particles accumulate in the oropharynx. If not properly removed, they could cause airway obstruction with concurrent hypoxia which may end fatally. Objectives: This study aims to highlight the importance of forgetting foreign objects in the airway in order to allert anesthesiologists about the hazards of missed foreign bodies in the oropharynx which could lead to disastrous situation. Patients and Methods: During the period from 2012-2014, out of 2300 patients presented for surgical operation under general anesthesia with endo-tracheal intubation, 22 patients were recorded to have accidental discovery of hazardous foreign bodies retained in the oropharynx and were included in this study with an incidence rate of 0.96%. Cases in this study were classified as patient-related or surgeryrelated. Foreign bodies were identified with the aid of laryngoscopy and were removed by suction hand piece or Magill's forceps. Results: The main age group was between 21-40 years accounting for 45.5%. Male: female ratio was 1.2:1. Overall, 59.1% were related to patients' causes, while 40.9% were related to surgery. The commonest type of foreign body observed was cardamom (38.5%) among patient-related cases, and tissue remnants in 66.7% of surgery-related cases. Conclusion: Missed foreign bodies are not uncommon and anesthesiologists should be aware of inspecting the mouth and throat of the patient thoroughly before endotracheal intubation and extubation to reduce the hazard of foreign body inhalation.
Monitoring of patients in the recovery room is considered the most serious part for safe anesthes... more Monitoring of patients in the recovery room is considered the most serious part for safe anesthesia. Anesthesiologists are some times so busy in completing the list of the operations so they can not follow up thoroughly their discharged patient from the theatre. This study determines the most common recovery room incidents in the last three years at AlSadir Teaching Hospital in Basrah. Of the about 7000 patients operated upon in this period, 669 patients (9.5%) had some event in the recovery room. The most common incident was respiratory problems (26%), irritability (22%), thermal (19%), cardiovascular (18%), nausea and vomiting (9%), low urine output (5%) and fall from couch (1%). Most of these incidents were treated immediately at the recovery room. The outcome was 5 deaths and 61 ICU admissions. Skilled anesthesia assistant present in the recovery room is the keystone for taking care and reducing recovery room incidents.
Monitoring of patients in the recovery room is considered the most serious part for safe
anesthe... more Monitoring of patients in the recovery room is considered the most serious part for safe
anesthesia. Anesthesiologists are some times so busy in completing the list of the
operations so they can not follow up thoroughly their discharged patient from the
theatre. This study determines the most common recovery room incidents in the last
three years at AlSadir Teaching Hospital in Basrah. Of the about 7000 patients operated
upon in this period, 669 patients (9.5%) had some event in the recovery room. The most
common incident was respiratory problems (26%), irritability (22%), thermal (19%),
cardiovascular (18%), nausea and vomiting (9%), low urine output (5%) and fall from
couch (1%). Most of these incidents were treated immediately at the recovery room. The
outcome was 5 deaths and 61 ICU admissions. Skilled anesthesia assistant present in
the recovery room is the keystone for taking care and reducing recovery room incidents.
Objective: The best laryngeal view can be obtained when external laryngeal manipulation is undert... more Objective: The best laryngeal view can be obtained when external laryngeal manipulation is undertaken by the anesthesiologist to improve glottis visualization and enhance endotracheal intubation. This study aimed
to evaluate the effectiveness of using anesthesiologist own left little finger to optimize laryngeal view during endotracheal intubation in small children. Methods: The study was conducted in Basra Teaching Hospital over a period from February 2013 to October 2013. Children below 5 years, ASA class I undergoing *Jasim M. Salman, MB, ChB, FICMS, Anesthesiology, Lecturer, University of Basra, Al-Sadir Teaching Hospital, Basrah, Iraq. E-mail: [email protected].
elective surgical procedures under general anaesthesia with endotracheal intubation were included in the study. The glottis view was assessed by direct laryngoscopy. The same patient was assigned into two groups; group A are those whose larynx is manipulated with the aid of an assistant using external pressure and direction on the larynx, while in group B, external laryngeal manipulation was undertaken by the anesthesiologist's left little finger to aid visualization of the larynx and the time to obtain the best view was recorded in both groups. Results: Out of 320 patients, seventy five patients who were included in the analysis have variable glottis view grading, a grade IIb was obtained in 54 cases, III in 19 cases, and grade IV in 2 cases. Grade I view was obtained in seventy two patients in group B vs 54 patients in group A (p<0.05). The time spent to obtain grade I view was significantly less in group B than in group A (p<0.05). Conclusions: In this study, the glottis was manipulated to obtain an optimal view using the left little finger for patients in whom the epiglottis could not be visualized with standard laryngoscopy to improve the laryngoscopic view. Furthermore, the use of this technique routinely in every patient regardless of grade makes the technique more easy and familiar
Background & Objective: With the extensive use of the laryngeal mask airway (LMA) for anesthesia ... more Background & Objective: With the extensive use of the laryngeal mask airway (LMA) for anesthesia as well as in emergency airway management, learning alternative techniques of insertion is essential for the safe and quick use of the device in some cases. The smooth and quick insertion of LMA leads without repeated attempts reduce the consequent complications. We compared standard technique with 180° rotation with inflated cuff technique for LMA Classic insertion. Methodology: This study was done in Basrah University Medical Center from 1st January 2019 to 31st December 2019. During this period, in 397 patients LMA was used for general anesthesia. Out of these, in 197 patients we used 180° rotation technique of insertion of LMA with fully inflated cuff and in 200 patients the standard method was used as a control group. The patients’ ages ranged between 15 and 45 y, and they were scheduled to undergo short surgical procedures and to require general anesthesia. Results: Three hundred a...
Objective: The best laryngeal view can be obtained when external laryngeal manipulation is undert... more Objective: The best laryngeal view can be obtained when external laryngeal manipulation is undertaken by the anesthesiologist to improve glottis visualization and enhance endotracheal intubation. This study aimed to evaluate the effectiveness of using anesthesiologist own left little finger to optimize laryngeal view during endotracheal intubation in small children. Methods: The study was conducted in Basra Teaching Hospital over a period from February 2013 to October 2013. Children below 5 years, ASA class I undergoing
Monitoring of patients in the recovery room is considered the most serious part for safe anesthes... more Monitoring of patients in the recovery room is considered the most serious part for safe anesthesia. Anesthesiologists are some times so busy in completing the list of the operations so they can not follow up thoroughly their discharged patient from the theatre. This study determines the most common recovery room incidents in the last three years at AlSadir Teaching Hospital in Basrah. Of the about 7000 patients operated upon in this period, 669 patients (9.5%) had some event in the recovery room. The most common incident was respiratory problems (26%), irritability (22%), thermal (19%), cardiovascular (18%), nausea and vomiting (9%), low urine output (5%) and fall from couch (1%). Most of these incidents were treated immediately at the recovery room. The outcome was 5 deaths and 61 ICU admissions. Skilled anesthesia assistant present in the recovery room is the keystone for taking care and reducing recovery room incidents.
Unpleasant drug incidents are common during medical action. In anesthetic practice, the probabili... more Unpleasant drug incidents are common during medical action. In anesthetic practice, the probability of errors is greater because of more tension and rapidity. Morbidity and even mortality are more expected in the course of anesthesia. Apart from many hazards that patients are exposed to such as; Biological hazards, Mechanical hazards, Chemical hazards, Physical hazards, and Personal Hazards 1 , it seems that danger of drug problems are more. The factors that make drug harm to a patient undergoing surgery through general anesthesia includes 2 , 3 .
ifficult intubation occurs relatively commonly in association with general anaesthesia. Its true ... more ifficult intubation occurs relatively commonly in association with general anaesthesia. Its true incidence is unknown but is estimated to be 1-3%. Approximately half of all cases are not predicted 1. A difficult intubation can be anticipated in a number of circumstances including a previous history of difficulty with intubation, syndromes known to be associated with difficulty to intubate, and some pathoanatomical states involving the head and neck region. Less reliable are anatomical characteristics which may be sought at preoperative assessment including interincisor distance 2 , Palm print 3 and prayer's signs 4 , head extension degree, thyromental distance 5 and the relative tongue/pharyngeal size 6 (Mallampati test). Inter-incisor distance Inter-incisor distance with maximal mouth opening < 3 cm: difficult laryngoscopy < 2 cm: difficult LMA insertion Other ways to anticipate difficult intubation in diabetics and patients with rheumatoid arthritis are the palm print and prayer signs. Palm Print Test: The palm and fingers of the dominant hand of the patient is painted with black writing ink using a brush. The patient then press the hand firmly against a white sheet of paper on a hard surface. Scoring is done as: Grade 0: All phalangeal areas visible. Grade1: Deficiency in the inter-phalangeal areas of 4th and/or 5th digit. Grade2: Deficiency in the inter-phalangeal areas of 2nd to 5th digit. Grade 3:Only the tips of digits seen.
From the time when succinylcholine(scoline) introduced to clinical anesthesia, intravenous route ... more From the time when succinylcholine(scoline) introduced to clinical anesthesia, intravenous route of administration of the drug has been broadly practiced. Severe bradycardia and arrhythmias may from time to time produced by single or frequent doses. The mechanism of bradycardia caused by succinylcholine administration has not been completely explained, it has been found that succinylcholine produce a unpredictable effects on the sinoatrial node. In our hospital , a second dose of succinylcholine is usually used for short surgical procedures that required good relaxation like anorectal surgery and orthopedic manipulation under anesthesia. This study aimed to discuss the conditions under which bradycardia appear during general anesthesia with oxygen, propofol, scoline, halothane, along with the use of second dose of scoline and assess the need for atropine to prevent this effect. Fifty patients aged between 20-50 years of American Society of Anesthesiologists (ASA) class I were included in this study, anesthesia was induced with propofol, scoline, along with oxygen halothane mixture, then 2nd dose of scoline was given 10 minutes later. Frequent pulse rate were recorded. There was considerable decrease in pulse rate of the patients after the 2nd dose of succinylcholine, 36% of the patients developed bradycardia (pulse rate below 60), and the mean reduction in pulse rate was (23±13 beats/min). However there is no need for the use of atropine since all of the patients return to normal rates (60-100 beats/min) within 1 minute spontaneously. Conclusion: It has been found that the use of scoline in one dose produce decrease in pulse rate but not reach to the bradycardia level, while the uses of another dose will result in significant reduction in pulse rate that can reach to the level of bradycardia. All patients return to normal level of pulse rate within 1 minute, therefore, there is no need to use atropine neither preoperatively nor after developing of bradycardia since it's a self limiting phenomenon.
Background: In anesthesia practice, obstructing materials like thick mucus secretion, debris or b... more Background: In anesthesia practice, obstructing materials like thick mucus secretion, debris or blood clots, and food particles accumulate in the oropharynx. If not properly removed, they could cause airway obstruction with concurrent hypoxia which may end fatally. Objectives: This study aims to highlight the importance of forgetting foreign objects in the airway in order to allert anesthesiologists about the hazards of missed foreign bodies in the oropharynx which could lead to disastrous situation. Patients and Methods: During the period from 2012-2014, out of 2300 patients presented for surgical operation under general anesthesia with endo-tracheal intubation, 22 patients were recorded to have accidental discovery of hazardous foreign bodies retained in the oropharynx and were included in this study with an incidence rate of 0.96%. Cases in this study were classified as patient-related or surgeryrelated. Foreign bodies were identified with the aid of laryngoscopy and were removed by suction hand piece or Magill's forceps. Results: The main age group was between 21-40 years accounting for 45.5%. Male: female ratio was 1.2:1. Overall, 59.1% were related to patients' causes, while 40.9% were related to surgery. The commonest type of foreign body observed was cardamom (38.5%) among patient-related cases, and tissue remnants in 66.7% of surgery-related cases. Conclusion: Missed foreign bodies are not uncommon and anesthesiologists should be aware of inspecting the mouth and throat of the patient thoroughly before endotracheal intubation and extubation to reduce the hazard of foreign body inhalation.
Monitoring of patients in the recovery room is considered the most serious part for safe anesthes... more Monitoring of patients in the recovery room is considered the most serious part for safe anesthesia. Anesthesiologists are some times so busy in completing the list of the operations so they can not follow up thoroughly their discharged patient from the theatre. This study determines the most common recovery room incidents in the last three years at AlSadir Teaching Hospital in Basrah. Of the about 7000 patients operated upon in this period, 669 patients (9.5%) had some event in the recovery room. The most common incident was respiratory problems (26%), irritability (22%), thermal (19%), cardiovascular (18%), nausea and vomiting (9%), low urine output (5%) and fall from couch (1%). Most of these incidents were treated immediately at the recovery room. The outcome was 5 deaths and 61 ICU admissions. Skilled anesthesia assistant present in the recovery room is the keystone for taking care and reducing recovery room incidents.
Monitoring of patients in the recovery room is considered the most serious part for safe
anesthe... more Monitoring of patients in the recovery room is considered the most serious part for safe
anesthesia. Anesthesiologists are some times so busy in completing the list of the
operations so they can not follow up thoroughly their discharged patient from the
theatre. This study determines the most common recovery room incidents in the last
three years at AlSadir Teaching Hospital in Basrah. Of the about 7000 patients operated
upon in this period, 669 patients (9.5%) had some event in the recovery room. The most
common incident was respiratory problems (26%), irritability (22%), thermal (19%),
cardiovascular (18%), nausea and vomiting (9%), low urine output (5%) and fall from
couch (1%). Most of these incidents were treated immediately at the recovery room. The
outcome was 5 deaths and 61 ICU admissions. Skilled anesthesia assistant present in
the recovery room is the keystone for taking care and reducing recovery room incidents.
Objective: The best laryngeal view can be obtained when external laryngeal manipulation is undert... more Objective: The best laryngeal view can be obtained when external laryngeal manipulation is undertaken by the anesthesiologist to improve glottis visualization and enhance endotracheal intubation. This study aimed
to evaluate the effectiveness of using anesthesiologist own left little finger to optimize laryngeal view during endotracheal intubation in small children. Methods: The study was conducted in Basra Teaching Hospital over a period from February 2013 to October 2013. Children below 5 years, ASA class I undergoing *Jasim M. Salman, MB, ChB, FICMS, Anesthesiology, Lecturer, University of Basra, Al-Sadir Teaching Hospital, Basrah, Iraq. E-mail: [email protected].
elective surgical procedures under general anaesthesia with endotracheal intubation were included in the study. The glottis view was assessed by direct laryngoscopy. The same patient was assigned into two groups; group A are those whose larynx is manipulated with the aid of an assistant using external pressure and direction on the larynx, while in group B, external laryngeal manipulation was undertaken by the anesthesiologist's left little finger to aid visualization of the larynx and the time to obtain the best view was recorded in both groups. Results: Out of 320 patients, seventy five patients who were included in the analysis have variable glottis view grading, a grade IIb was obtained in 54 cases, III in 19 cases, and grade IV in 2 cases. Grade I view was obtained in seventy two patients in group B vs 54 patients in group A (p<0.05). The time spent to obtain grade I view was significantly less in group B than in group A (p<0.05). Conclusions: In this study, the glottis was manipulated to obtain an optimal view using the left little finger for patients in whom the epiglottis could not be visualized with standard laryngoscopy to improve the laryngoscopic view. Furthermore, the use of this technique routinely in every patient regardless of grade makes the technique more easy and familiar
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anesthesia. Anesthesiologists are some times so busy in completing the list of the
operations so they can not follow up thoroughly their discharged patient from the
theatre. This study determines the most common recovery room incidents in the last
three years at AlSadir Teaching Hospital in Basrah. Of the about 7000 patients operated
upon in this period, 669 patients (9.5%) had some event in the recovery room. The most
common incident was respiratory problems (26%), irritability (22%), thermal (19%),
cardiovascular (18%), nausea and vomiting (9%), low urine output (5%) and fall from
couch (1%). Most of these incidents were treated immediately at the recovery room. The
outcome was 5 deaths and 61 ICU admissions. Skilled anesthesia assistant present in
the recovery room is the keystone for taking care and reducing recovery room incidents.
to evaluate the effectiveness of using anesthesiologist own left little finger to optimize laryngeal view during endotracheal intubation in small children. Methods: The study was conducted in Basra Teaching Hospital over a period from February 2013 to October 2013. Children below 5 years, ASA class I undergoing *Jasim M. Salman, MB, ChB, FICMS, Anesthesiology, Lecturer, University of Basra, Al-Sadir Teaching Hospital, Basrah, Iraq. E-mail: [email protected].
elective surgical procedures under general anaesthesia with endotracheal intubation were included in the study. The glottis view was assessed by direct laryngoscopy. The same patient was assigned into two groups; group A are those whose larynx is manipulated with the aid of an assistant using external pressure and direction on the larynx, while in group B, external laryngeal manipulation was undertaken by the anesthesiologist's left little finger to aid visualization of the larynx and the time to obtain the best view was recorded in both groups. Results: Out of 320 patients, seventy five patients who were included in the analysis have variable glottis view grading, a grade IIb was obtained in 54 cases, III in 19 cases, and grade IV in 2 cases. Grade I view was obtained in seventy two patients in group B vs 54 patients in group A (p<0.05). The time spent to obtain grade I view was significantly less in group B than in group A (p<0.05). Conclusions: In this study, the glottis was manipulated to obtain an optimal view using the left little finger for patients in whom the epiglottis could not be visualized with standard laryngoscopy to improve the laryngoscopic view. Furthermore, the use of this technique routinely in every patient regardless of grade makes the technique more easy and familiar
anesthesia. Anesthesiologists are some times so busy in completing the list of the
operations so they can not follow up thoroughly their discharged patient from the
theatre. This study determines the most common recovery room incidents in the last
three years at AlSadir Teaching Hospital in Basrah. Of the about 7000 patients operated
upon in this period, 669 patients (9.5%) had some event in the recovery room. The most
common incident was respiratory problems (26%), irritability (22%), thermal (19%),
cardiovascular (18%), nausea and vomiting (9%), low urine output (5%) and fall from
couch (1%). Most of these incidents were treated immediately at the recovery room. The
outcome was 5 deaths and 61 ICU admissions. Skilled anesthesia assistant present in
the recovery room is the keystone for taking care and reducing recovery room incidents.
to evaluate the effectiveness of using anesthesiologist own left little finger to optimize laryngeal view during endotracheal intubation in small children. Methods: The study was conducted in Basra Teaching Hospital over a period from February 2013 to October 2013. Children below 5 years, ASA class I undergoing *Jasim M. Salman, MB, ChB, FICMS, Anesthesiology, Lecturer, University of Basra, Al-Sadir Teaching Hospital, Basrah, Iraq. E-mail: [email protected].
elective surgical procedures under general anaesthesia with endotracheal intubation were included in the study. The glottis view was assessed by direct laryngoscopy. The same patient was assigned into two groups; group A are those whose larynx is manipulated with the aid of an assistant using external pressure and direction on the larynx, while in group B, external laryngeal manipulation was undertaken by the anesthesiologist's left little finger to aid visualization of the larynx and the time to obtain the best view was recorded in both groups. Results: Out of 320 patients, seventy five patients who were included in the analysis have variable glottis view grading, a grade IIb was obtained in 54 cases, III in 19 cases, and grade IV in 2 cases. Grade I view was obtained in seventy two patients in group B vs 54 patients in group A (p<0.05). The time spent to obtain grade I view was significantly less in group B than in group A (p<0.05). Conclusions: In this study, the glottis was manipulated to obtain an optimal view using the left little finger for patients in whom the epiglottis could not be visualized with standard laryngoscopy to improve the laryngoscopic view. Furthermore, the use of this technique routinely in every patient regardless of grade makes the technique more easy and familiar