Comparison of laryngoscopic view and intubation conditions in "BURP" and "Modified BURP" maneuvers

Background: Role of anesthesiologist is important in difficult intubation and laryngoscopy and the role of an expert assistant performing the required maneuvers is important as well. Nevertheless, these maneuvers cannot be efficient during intubation in some cases because of inadequate experience of assistants. Therefore, in this study we compared the degree of laryngoscopic view and intubation condition using BURP and Modified BURP maneuvers.

Methods: Patients were randomly divided into two groups of study based on entering to the operation room. Premedication and induction of anesthesia were performed similarly in both groups. Later, laryngoscopy and intubation were performed. In control group, anesthesiologist recorded the visualized degree. Assistant was asked to perform maneuvers to improve laryngoscopic view. In case group, after recording the initial laryngoscopic view, anesthesiologist improved laryngoscopic view by his right hand and asked his assistant to intubate the patient. Then degree of improvement of visualization and success of intubation in two groups were compared.

Results: The mean time required for intubation was significantly more in the control group (P<0.001). In case group, laryngoscopic view improved significantly more than the control group (P=0.005). Nevertheless, the success of intubation was equal in both groups with no significant difference.

Conclusion: Findings of this study indicate that modified BURP provides better view of laryngoscopy compared to BURP. Both methods and maneuvers are equally effective regarding the success of intubation.