The Effect of Brief Pre-Anesthetic Jaw and Neck Exercises on Intubation Conditions During General Anesthesia: A Prospective Interventional Study

Abstract

Background: Airway management remains a critical component of anesthetic practice. Restricted mouth opening and reduced neck mobility are established risk factors for difficult laryngoscopy and tracheal intubation. This study evaluated whether a brief pre-anesthetic jaw and neck exercise regimen could improve airway parameters and intubation conditions.

Methods: A prospective interventional study was conducted among 100 ASA I–II patients aged 20–70 years undergoing elective surgery under general anesthesia. Patients were allocated into exercise and control groups. The exercise group performed a 5‑minute jaw and neck exercise program before anesthetic induction. Mouth opening, Mallampati score, sternomental distance, intubation time, Cormack–Lehane grade, Intubation Difficulty Scale (IDS), and soft tissue injury were assessed. Statistical analysis included Student’s t-test, paired t-test, Chi-square test, and Fisher’s exact test.

Results: Patients performing exercises demonstrated significant improvement in mouth opening and Mallampati grading. Mean mouth opening increased to 51.3 ± 6.4 mm compared with 49.0 ± 7.5 mm in controls. Mallampati Grade I was more frequent in the exercise group. Intubation time was significantly reduced (12.5 vs. 18.8 seconds). Soft tissue injury occurred less frequently in the exercise group. IDS scores showed a favorable trend toward easier intubation.

Conclusion: A brief preoperative jaw and neck exercise regimen improves airway dimensions and facilitates tracheal intubation. The intervention is simple, inexpensive, non-invasive, and may enhance perioperative airway safety.