Comparison of Three Laryngoscopes in Difficult Laryngoscopy

Not Applicable

Completed

• Conditions: Intubation; Difficult
• Interventions: Device: Intubation- Macintosh laryngoscope; Device: Intubation- MacCoy laryngoscope; Device: Intubation- Airtraq laryngoscope

• Registration Number: NCT02387502
• Lead Sponsor: Government Medical College, Haldwani

Brief Summary

Tracheal intubation requires alignment of oro-pharyngeal-laryngeal axes. When these three axes are not aligned, intubation becomes difficult. In the researchers' study, the investigators simulated difficult laryngoscopy situation by using a rigid neck collar. This neck collar renders intubation difficult not only by restricting neck movement, but also reducing mouth opening. The investigators compared the performance of Macintosh, MacCoy and Airtraq laryngoscope in simulated difficult laryngoscopy using a rigid neck collar.

Detailed Description

Airtraq laryngoscope is an optical laryngoscope which allows visualization of vocal cord as a reflected image through multiple lenses and prisms. MacCoy laryngoscope is a modification of Macintosh laryngoscope. It has a lever which, when pressed, moves its flexible tip. In the investigators' study, the researchers compared the performances of Airtraq laryngoscope with MacCoy and Macintosh laryngoscopes in simulated difficult laryngoscopy using a rigid neck collar. The researchers recruited 120 patients and randomly divided those patients into three equal groups i.e. 30 patients in each group. These three groups are 1-Airtraq, 2-MacCoy and 3-Macintosh. The researchers compared efficacy and safety in these three laryngoscopes. The researchers compared efficacy in terms of time of intubation, ease of intubation, overall success, Intubation difficulty score, visualization of vocal cord in terms of POGO (percentage of Glottic Opening) score. The researchers compared safety in terms of hemodynamic pressor response and airway trauma.

Study Timeline

• Study Start: 2014-01
• Primary Completion: 2014-12
• Study Completion: 2014-12
• Study First Submitted: 2015-03-02
• Study First Submitted QC: 2015-03-12
• Study First Posted: 2015-03-13
• Results First Submitted: 2015-03-27
• Status Verified: 2015-04
• Results First Submitted QC: 2015-04-28
• Last Update Submitted: 2015-04-28
• Results First Posted: 2015-05-04
• Last Update Posted: 2015-05-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 120

Inclusion Criteria

• American Society of Anesthesiologists (ASA) physical status I and II.
• Posted for elective surgery requiring general anesthesia and tracheal intubation

Exclusion Criteria

• patients with anticipated difficult airway
• obese (body mass index (BMI)>30) patients
• patients with risk of pulmonary aspiration of gastric contents
• pregnant patients
• patients with airway distortion or trauma.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Intubation with Macintosh laryngoscope	Intubation- Macintosh laryngoscope	40 patients were intubated with Macintosh laryngoscope after simulating difficult laryngoscopy using rigid neck collar.
Intubation with MacCoy laryngoscope	Intubation- MacCoy laryngoscope	40 patients were intubated with MacCoy laryngoscope after simulating difficult laryngoscopy using rigid neck collar.
Intubation with Airtraq laryngoscope	Intubation- Airtraq laryngoscope	40 patients were intubated with Airtraq laryngoscope after simulating difficult laryngoscopy using rigid neck collar.

Primary Outcome Measures

Name	Time	Method
Time of Intubation	up to 10 minutes	Time of intubation is defined as the time from passing the device beyond the incisors to the confirmation of endotracheal tube placement by square wave capnograph tracings.