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A Comparison of C-MAC Videolaryngoscopy and Direct Laryngoscopy for Nasotracheal Intubation

Not Applicable
Completed
Conditions
Intubation
Children
Videolaryngoscopy
Interventions
Device: C-MAC videolaryngoscope
Device: Direct Laryngoscope
Registration Number
NCT03908775
Lead Sponsor
Inonu University
Brief Summary

Nasotracheal intubation is indicated in patients undergoing oral, maxillofacial, or dental procedures. During nasal intubation with the traditional Macintosh laryngoscope, use of Magill's forceps or external laryngeal manipulation is usually required to facilitate intubation. The prolonged or multiple intubation attempts and, subsequently, may be associated with complications such as oxygen desaturation or airway and dental injuries.

The C-MAC videolaryngoscope (Karl Storz, Tuttlingen, Germany) is a videolaryngoscope using a modified Macintosh blade, which may be a useful alternative both for routine and difficult airway management and for educational purposes.

In this prospective, randomized, controlled trial, the purpose is to compare C-MAC and DL in terms of intubation times, hemodynamic response and adverse events associated with nasotracheal intubation in children undergoing dental procedures.

Detailed Description

Tracheal intubation using direct laryngoscopy is successful in the majority of patients, even when a line-of-sight view of the glottis is not possible. Although poor glottic visualization is encountered between 1% and 9% of attempts, success can generally be achieved with additional force, external laryngeal manipulation, or the use of gum elastic bougies and stylets. However, poor glottic exposure is more likely to require prolonged or multiple intubation attempts and, subsequently, may be associated with complications such as oxygen desaturation or airway and dental injuries. In recent years, videolaryngoscopy has begun to play an important role in the management of patients with an unanticipated difficult or failed laryngoscopic intubation.

The C-MAC videolaryngoscope (Karl Storz, Tuttlingen, Germany) is a videolaryngoscope using a modified Macintosh blade, which may be a useful alternative both for routine and difficult airway management and for educational purposes.

In this prospective, randomized, controlled trial, the purpose is to compare C-MAC and DL in terms of intubation times, hemodynamic response and adverse events associated with nasotracheal intubation in children undergoing dental procedures.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
102
Inclusion Criteria
  • 3-12 years
  • American Society of Anesthesiology score I-II,
  • undergoing dental procedure
  • required nasotracheal intubation
Exclusion Criteria
  • Patients for risk of aspiration
  • Upper airway abnormalities
  • Known difficult airways

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Group VLC-MAC videolaryngoscopeC-MAC Videolaryngoscope Patients intubated with C-MAC Videolaryngoscope
Group DLDirect LaryngoscopeDirect Laryngoscope Patients intubated with Direct laryngoscope
Primary Outcome Measures
NameTimeMethod
Time to intubationFrom beginning of inserting nasotracheal tube into nares to seeing two meaningful end-tidal carbon dioxide levels up to 3 minutes

Time to intubation was defined as the time the nasotracheal tube was inserted into nares the until endtidal CO2 was detected

Secondary Outcome Measures
NameTimeMethod
Heart RateFrom beginning of Anesthesia induction to 10th minutes of intubation

Heart Rate

Mean Arterial PressureFrom beginning of Anesthesia induction to 10th minutes of intubation

Mean Arterial Pressure

Adverse EventsDuring the first 1 hour postoperatively

Bleeding in the mouth and nose, the Magill Forceps use, burst of intubation tube cuff, external laryngeal pressure, presence of head position change, laryngospasm, hypoxia.

Trial Locations

Locations (1)

Inonu University

🇹🇷

Malatya, Turkey

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