Point of Care Upper Airway Ultrasound in the Assessment of Difficult Visualization of the Larynx in Obese Patients Undergoing Bariatric Surgery: a Comparison With the Conventional Cormack-Lehane Classification During Direct Laryngoscopy: an Observational Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 111
- 试验地点
- 1
- 主要终点
- Epiglottis-to-vocal-cord distance
研究概览
简要总结
failed and Difficult tracheal intubation after direct laryngoscopy is a dreaded complication of general anesthesia as it is associated with serious morbidity and mortality. There are several conventional clinical airway assessment parameters such as the modified Mallampati classification,thyromental and hyomental distance, interincisor distance, neck movementsand neck circumference, which are usually used to predict a difficult airwayand are components of multivariate risk indices. Despite the use of these parameters, the diagnostic accuracy of a preanesthetic airway assessment in predicting difficult intubation is very low. Ultrasound has been evolving as a useful device for airway assessment,and sublingual ultrasound has been used for this purpose.
详细描述
By an anesthesiologist who is experienced in airway ultrasound, patients will preoperative sonographic assessment . the patient will lie in the ramped up position , with head in the neutral position.The linear probe of the ultrasound machine will be used. Under the patient's chin, The probe of ultrasond will be placed , at different levels, to get the of the submandibular area in transverse view and the upper part of the neck. The transverse view will be used for measuring the the skin to hyoid, tongue volume,and the skin to epiglottis distance. The mid-sagittal view will be used for measuring the distance between epiglottis ,pre-epiglottic space , vocal cords, and the neck fat volume .
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Adult patients above 18 years of age.
- •Both genders
- •Patients scheduled for elective surgery under general anesthesia
- •Obese patients with BMI > 30 kg/m2
排除标准
- •Patients with psychological disorders or those lacking co-operation.
- •Patients with maxillofacial anomalies, restricted neck movements and limited mouth opening.
- •American Society of Anesthesiologists (ASA) physical status class IV
- •Emergency operations
研究组 & 干预措施
preoperative sonographic assessment group
preoperative sonographic assessment to airway
干预措施: sonographic assessment (Radiation)
结局指标
主要结局
Epiglottis-to-vocal-cord distance
时间窗: during examination up to 1 hours
Epiglottis-to-vocal-cord distance by ultrasound
次要结局
- Tongue width(UP TO 1 HOURE)
- Modified Mallampati class(UP TO 1 HOURE)
- the time needed to perform the ultrasound examination.(UP TO 1 HOURE)
- Pre-epiglottic space(up to 1 hour)
- Skin to hyoid distance(up to 1 hour)
- Skin to epiglottis distance(up to 1 hour)
- Pre-epiglottic space(UP TO 1 HOURE)
研究者
Amr Samir Wahdan
Lecturer of Anesthesia, Pain management and Surgical ICU
Cairo University