Retromolar Route Access With and Without A Retromolar Gap - A Visualization Study Of The Vocal Cords
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Medical University of Vienna
- Enrollment
- 40
- Locations
- 2
- Primary Endpoint
- Cormack & Lehane score (without a backward, upward, rightwards pressure maneuver)
Study Overview
Brief Summary
Retromolar Intubation is a successful option for intubation in patients with an existing retromolar gap in the case that the conventional method fails.
Therefore the investigators want to test if the retromolar gap is essential for performing the retromolar intubation technique.
Detailed Description
For successful endotracheal intubation an optimal visualisation of the vocal cords is essential. A study comparing retromolar and conventional laryngoscopy showed in patients with an existing retromolar gap, that the retromolar technique is superior for endotracheal intubation especially in patients with a failed 'conventional' intubation attempt. The aim of the following study is to test if a retromolar gap at the right mandible is necessary for the successful performance of the retromolar laryngoscopy technique.
Therefore, 20 patients with and 20 patients without a retromolar gap will be investigated.
The anesthesiologist will visually determine the view of the vocal cords and score it according to Cormack & Lehane. For an improved view a backward, upward, right-ward pressure (BURP) will be performed, if needed, and scored again.
Finally, endotracheal intubation will be performed by the 'conventional' intubation method. If, however, intubation is not possible, then the retromolar technique will be used. In the case that both methods fail, then any (other) intubation method will (can) be used.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Other
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 99 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •BMI < 35kg/m2
- •Elective surgery
- •Absence of at least one molar of the right mandible in arm I (20 patients)
Exclusion Criteria
- •Emergency patients
- •Prevalence of reflux disease
- •Toothless patients
- •Diaphragmatic hernia
- •Patient is not sober
- •Ventilation problems during induction of anaesthesia
- •Patient with a tracheostomy
Arms & Interventions
Patient with Retromolar Gap
20 patients with a retromolar gap between the last erupted molar and the ascending ramus at the right lower mandible.
Intervention: Retromolar laryngoscopy and scoring of the visualisation of the vocal cords according to Cormack & Lehane (Procedure)
Patient without a Retromolar Gap
20 patients without a retromolar gap between the last erupted molar and the ascending ramus at the right lower mandible.
Intervention: Retromolar laryngoscopy and scoring of the visualisation of the vocal cords according to Cormack & Lehane (Procedure)
Outcomes
Primary Outcomes
Cormack & Lehane score (without a backward, upward, rightwards pressure maneuver)
Time Frame: At least 2 minutes after muscle relaxation
After ensuring sufficient bag-mask ventilation, the scoring of the vocal cords according to Cormack \& Lehane will be performed at least 2 minutes after administration of the muscle relaxant rocuronium without a backward, upward, rightwards pressure maneuver (=BURB)
Cormack & Lehane score (with a backward, upward, rightwards pressure maneuver)
Time Frame: Approximately 5-10 seconds after the collection of the Outcome Measure 1
If the Outcome Measure 1 does not reveal a 100% visualization of the vocal cords, a backward, upward, rightwards pressure maneuver (BURP) maneuver will be applied and scored again according to Cormack \& Lehane . Usually each of the two scoring procedures lasts approximately 5-10 seconds.
Secondary Outcomes
No secondary outcomes reported
Investigators
Wolfgang SCHRAMM
Ao Univ. Prof. Dr. med. univ.
Medical University of Vienna