New Maneuver to Facilitate Fiberoptic Intubation for Difficult Airway

Not Applicable

Completed

• Conditions: Anticipated Difficult Airway
• Interventions: Other: Sham; Other: Lingual Traction; Device: Fiberoptic Intubation

• Registration Number: NCT01958346
• Lead Sponsor: Enrico Camporesi

Brief Summary

We propose the additional technique of lingual traction or "tongue pulling" in conjunction with use of the flexible fiberoptic bronchoscope for facilitating successful first attempts at and decreasing time to intubation of the difficult airway and rescuing otherwise failed intubation attempts. Induction of general anesthesia causes relaxation and approximation of the soft palate, base of the tongue, epiglottis, and posterior pharyngeal wall, creating unfavorable anatomic changes in the pharynx for successful intubation. The use of lingual traction can assist in diminishing these problems by clearing the tongue away from the soft palate and uvula and lifting the epiglottis from the posterior pharyngeal wall, especially in the unanticipated difficult airway patient.

Detailed Description

Not available

Study Timeline

• Study Start: 2012-06
• Primary Completion: 2013-09
• Study First Submitted: 2013-10-04
• Study First Submitted QC: 2013-10-08
• Study First Posted: 2013-10-09
• Study Completion: 2013-11
• Results First Submitted: 2015-12-02
• Status Verified: 2016-08
• Results First Submitted QC: 2016-08-02
• Last Update Submitted: 2016-08-02
• Results First Posted: 2016-09-12
• Last Update Posted: 2016-09-12

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 78

Inclusion Criteria

• > 18 years old
• With ASA (American Society of Anesthesiologists) physical status I-III
• With anticipated difficult airway
• Scheduled for elective surgery requiring orotracheal intubation (populations such as elective hip and knee arthroplasty patients)
• Provide written consent

Exclusion Criteria

• With (American Society of Anesthesiologists) ASA physical status IV
• Pregnant
• Require rapid-sequence induction
• Require a non-standard tracheal tub
• Unable to provide written consent
• At risk for pulmonary aspiration of gastric content

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Fiberoptic Intubation Alone	Fiberoptic Intubation	Intubation with fiberoptic scope assistance
Fiberoptic Intubation Alone	Sham	Intubation with fiberoptic scope assistance
Fiberoptic Intubation with lingual traction	Lingual Traction	Intubation with fiberoptic scope assistance and lingual traction maneuver provided by a second anesthesiologist
Fiberoptic Intubation with lingual traction	Fiberoptic Intubation	Intubation with fiberoptic scope assistance and lingual traction maneuver provided by a second anesthesiologist

Primary Outcome Measures

Name	Time	Method
Number of Participants With Successful Intubations on First Attempt; Grade(s) Were Not Measured.	At Intubation

Secondary Outcome Measures

Name	Time	Method
Sore Throat Grade on First Postoperative Day	Postoperative day one	Patients will be asked to rate their sore throat qualitatively as none, mild, moderate, or severe

Trial Locations

Locations (1)

Tampa General Hospital; 🇺🇸 Tampa, Florida, United States