Inclusion Criteria:  Patients requiring general anesthesia with tracheal intubation for elective MLS Age ≥ 18  Exclusion Criteria:  Pregnant or breastfeeding women Confirmed indications for awake fiberoptic intubation Planned endotracheal intubation without deep anesthesia or neuromuscular blocking agents (e.g. awake videolaryngoscopy) Patients at risk for pulmonary aspiration who qualify for rapid sequence induction Cardiac pacemaker Atrial fibrillation Denial of consent