The wide variety of airway armamentarium available today may be broadly classified as infraglottic
and supraglottic airway devices, which are employed to protect airway in both elective and emergency situations.
Hassan17 concluded that during laryngoscopy, actual placing of endotracheal tube through the cords and inflating the cuff in infraglottic
region contribute significantly to sympatho-adrenal upsurges, again supporting our findings in elderly as Ismail18 observed exaggerated increase in Systolic blood pressure following laryngoscopy and intubation in elderly and middle aged patients as compared to young depicting the importance of age and variance in balance between sympathetic and parasympathetic outflow which is also in our selected aged population.
A plausible exception where even such an ideal intubation device may fail would be in the presence of an infraglottic
pathology that prevents the advancement of a tracheal tube beyond the glottis.
In each case, this complication was caused by the management of the orotracheal tube, which should be pulled back just in the infraglottic
area under fibreoptic guidance and not mobilised during the procedure.