Anesth Pain Med.  2021 Oct;16(4):391-397. 10.17085/apm.21026.

The effects of backward, upward, rightward pressure maneuver for intubation using the OptiscopeTM: a retrospective study

  • 1Department of Anesthesiology and Pain Medicine, Seoul Medical Center, Seoul, Korea


The OptiscopeTM and the backward, upward, rightward pressure (BURP) maneuver are widely used in clinical practice because the BURP maneuver facilitates intubation by improving visualization of the larynx. However, the effect of the BURP maneuver is unclear when using the OptiscopeTM. Therefore, we retrospectively investigated the effect of the BURP maneuver on intubation using the OptiscopeTM.
Sixty-eight patients intubated with the OptiscopeTM were enrolled. We used the BURP maneuver in Group A (n = 33) and the conventional maneuver (which does not use the BURP maneuver) in Group B (n = 35). BURP application status was a binary variable representing whether the BURP maneuver was used during the intubation. A multiple linear regression analysis was performed to assess the effects of the BURP application status on intubation time controlling for body mass index, preoperative dental injury status, obstructive sleep apnea history, thyromental distance, sternomental distance (SMD), interincisor distance, history of neck rotation restriction, and Mallampati classification.
There was no difference in the intubation time between the two groups. According to the regression model (R2 = 0.308, P = 0.007), the BURP maneuver (Group A) decreased the intubation time by 6.089 seconds (95% confidence interval 1.303–10.875, P = 0.014) compared to Group B.
The BURP maneuver reduced intubation time when using the OptiscopeTM.


BURP maneuver; Intubation time; Optiscope; Sternomental distance


  • Fig. 1. BURP maneuver. BURP: Backward, Upward, Rightward Pressure.


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