The Efficacy of the "BURP" Maneuver During a Difficult Laryngoscopy

TLDR

The BURP maneuver involves posterior, superior, and right‑lateral displacement of the larynx to improve visualization during laryngoscopy. The study aimed to assess whether the BURP maneuver improves laryngeal visualization during laryngoscopy. The authors enrolled 630 patients without head‑neck malformations, graded laryngeal visualization into five levels, and compared BURP to standard laryngoscopy with or without simple back pressure. BURP significantly enhanced laryngeal visualization compared to initial inspection and outperformed simple back pressure. Anesth Analg 1997;84:419‑21.

Abstract

The displacement of the larynx in the three specific directions (a) posteriorly against the cervical vertebrae, (b) superiorly as possible, and (c) slightly laterally to the right have been reported and named the "BURP" maneuver.We evaluated the efficacy of the BURP maneuver in improving visualization of the larynx. Six hundred thirty patients without obvious malformation of the head and neck participated in this study. We divided the degree of visualization of the larynx using laryngoscopy into five grades and compared the visualization of the larynx using the BURP maneuver with that of laryngoscopy with and without simple laryngeal pressure ("Back"). The maneuver of Back and BURP significantly improved the laryngoscopic visualization from initial inspection. The BURP maneuver also significantly improved the visualization compared with the Back maneuver. We concluded that the BURP maneuver improved the visualization of the larynx more easily than simple back pressure on the larynx. (Anesth Analg 1997;84:419-21)