A Randomized Trial on Comparison of Effects of Two Lightwand Intubation Techniques on Cervical Spine Motion: Laryngoscope-assisted vs. Conventional Lightwand Intubation
Trial Snapshot
- Phase
- Not Applicable
- Enrollment
- 22
- Primary Endpoint
- maximum cervical spine motion
Study Overview
Brief Summary
The aim of the study is to compare the effect of the laryngoscope-assisted lightwand intubation technique vs. the conventional lightwand intubation technique on the cervical spine motion during intubation in patients with the simulated cervical immobilization.
Detailed Description
In clinical practice, the investigators have occasionally experienced some difficulties in the lightwand intubation in patients with cervical spine instability because manual in-line stabilization during intubation hinders free movements of the lightwand such as advancement, withdrawal, and scooping in the oral cavity. For this reason, jaw thrust is often used to secure enough space for free movements of the lightwand in the oral cavity in the traditional lightwand intubation technique. A recent study showed that laryngoscope-assisted lightwand intubation provided more successful intubation on the first attempt and less scooping movement than the traditional lightwand intubation by facilitating free movements of the lightwand in the oral cavity in patients with cervical immobilization during intubation for cervical spine surgery. In the laryngoscope-assisted lightwand intubation technique, the direct laryngoscope may provide sufficient space for free movements of the lightwand in the oral cavity without jaw thrust, which can result in cervical spine movement. However, the effect of the laryngoscope-assisted lightwand intubation technique on cervical spine motion is not investigated yet.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Crossover
- Masking
- Double (Participant, Outcomes Assessor)
Eligibility Criteria
- Ages
- 18 Years to 80 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients with American Society of Anesthesiologists physical status of 1-2 and age of 18-80 years undergoing elective endovascular coiling to secure cerebral aneurysm under general anesthesia in neuroangiographic rooms.
Exclusion Criteria
- •Patients with the upper airway abnormalities, such as inflammation, abscesses, tumours, polyps, or trauma.
- •Patients with past medical history of gastro-oesophageal reflux disease and previous airway surgery, a high risk of aspiration, coagulation disorders, or Hunt Hess grade of 3-
- •Body mass index > 30
Arms & Interventions
Group A
laryngoscope-assisted lightwand intubation - traditional lightwand intubation
Intervention: laryngoscope-assisted lightwand intubation (Device)
Group A
laryngoscope-assisted lightwand intubation - traditional lightwand intubation
Intervention: traditional lightwand intubation (Device)
Group B
traditional lightwand intubation - laryngoscope-assisted lightwand intubation
Intervention: laryngoscope-assisted lightwand intubation (Device)
Group B
traditional lightwand intubation - laryngoscope-assisted lightwand intubation
Intervention: traditional lightwand intubation (Device)
Outcomes
Primary Outcomes
maximum cervical spine motion
Time Frame: during tracheal intubation
maximum angles measured at the occiput-C1, C1-C2, C2-C5 segments.
Secondary Outcomes
- number of intubation trial(during tracheal intubation)
- sore throat, pain score(after extubation ~ postoperative day 1)
- intubation time(during tracheal intubation)