Comparison of Cuff Inflation and Conventional Technique for Nasotracheal Intubation using C-MAC Video Laryngoscope. A Prospective Randomised Controlled Trial.
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Enrollment
- 106
- Locations
- 1
- Primary Endpoint
- Primary outcome of our study is Time taken for ETT placement(defined as time taken after the confirmation of tip of endotracheal tube in nasopharynx by C-MAC video laryngoscope to the appearance of three successive end tidal CO2 waveforms.
Study Overview
Brief Summary
Surgical procedure involving head and neck region, intraoral, maxillofacial and dental procedures usually mandate nasotracheal intubation (NTI). Advantage of NTI is that it better isolates surgical field from artificial airway so that the endotracheal tube is less vulnerable to kinking, damage due to surgical instrumentations. In addition, postoperatively nasal tube is better tolerated than the oral route and require less sedation. Nasotracheal intubation involve passing of tube through one of the nostril till the tube reaches nasopharynx and then with help of video or macintosh laryngoscope it is guided through vocal cord by various manoeuvres like burp, neck movement, tube rotation, use of bougie or by using Magill’s forceps. These manoeuvres lead to longer intubation time, trauma, bleeding of nasopharyngeal wall and hemodynamic stress response while negotiating the tube into trachea.
Cuff inflation technique (wherein the cuff of ET tube is inflated with air) in which after inflation of the cuff the endotracheal tube is lifted away from the posterior pharyngeal wall and gets aligned with the laryngeal inlet and tip of the tracheal tube is engaged with the glottis opening. Once the tip of tube passes through the glottis, cuff is deflated and tube is further advanced.
Cuff inflation technique has not been compared with conventional technique yet. Hence, we plan to compare these two techniques of nasal intubation. We hypothesize that cuff inflation technique will have faster intubation time and less manipulation in comparison to conventional nasal intubation technique.
Study Design
- Study Type
- Interventional
- Allocation
- Computer generated randomization
- Masking
- Open Label
Eligibility Criteria
- Ages
- 18.00 Year(s) to 65.00 Year(s) (—)
- Sex
- All
Inclusion Criteria
- •1 Patient scheduled for elective surgery requiring nasal intubation 2 American Society of Anaesthesiologists (ASA) physical status 1-2.
Exclusion Criteria
- •1 Patient refusal 2 known difficult Airway 3 Patient with mouth opening <2.5cm 4 Patient difficult to mask ventilate 5 History of larynx surgery or larynx radiotherapy 6 Anticipated esophago-tracheal reflux 7 mallampati view 3 or 4 8 Frequent episodes of epistaxis or bleeding tendency 9 patients with significant systemic disease 10 Patient having Contraindications for NTI.
Outcomes
Primary Outcomes
Primary outcome of our study is Time taken for ETT placement(defined as time taken after the confirmation of tip of endotracheal tube in nasopharynx by C-MAC video laryngoscope to the appearance of three successive end tidal CO2 waveforms.
Time Frame: Primary outcome of our study is Time taken for ETT placement(defined as time taken after the confirmation of tip of endotracheal tube in nasopharynx by C-MAC video laryngoscope to the appearance of three successive end tidal CO2 waveforms by the end of 1 minute, beyond one minute attempt is considered a failure.
Secondary Outcomes
- 1 Type and number of manoeuvres (M1-M4) used(2 Hemodynamic response to intubation)