Laryngoscope-assisted Lightwand Intubation and Cervical Spine Motion

Not Applicable

• Conditions: Intubation; Difficult
• Interventions: Device: laryngoscope-assisted lightwand intubation; Device: traditional lightwand intubation

• Registration Number: NCT02430415
• Lead Sponsor: Seoul National University Hospital

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 Timeline

• Status Verified: 2015-04
• Study First Submitted: 2015-04-22
• Study First Submitted QC: 2015-04-26
• Last Update Submitted: 2015-04-26
• Study First Posted: 2015-04-30
• Last Update Posted: 2015-04-30
• Study Start: 2015-05
• Primary Completion: 2016-04
• Study Completion: 2017-04

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 22

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.

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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 3-5.
• Body mass index > 30

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Group A	traditional lightwand intubation	laryngoscope-assisted lightwand intubation - traditional lightwand intubation
Group A	laryngoscope-assisted lightwand intubation	laryngoscope-assisted lightwand intubation - traditional lightwand intubation
Group B	traditional lightwand intubation	traditional lightwand intubation - laryngoscope-assisted lightwand intubation
Group B	laryngoscope-assisted lightwand intubation	traditional lightwand intubation - laryngoscope-assisted lightwand intubation

Primary Outcome Measures

Name	Time	Method
maximum cervical spine motion	during tracheal intubation	maximum angles measured at the occiput-C1, C1-C2, C2-C5 segments.

Secondary Outcome Measures

Name	Time	Method
number of intubation trial	during tracheal intubation
sore throat, pain score	after extubation ~ postoperative day 1
intubation time	during tracheal intubation