Efficiency of the King Vision Video Laryngoscope

Not Applicable

Completed

Conditions: Intubation
Respiratory Failure

Interventions: Device: Macintosh laryngoscope
Device: King Vision video laryngoscope

Registration Number: NCT02482870

Lead Sponsor: Recep Tayyip Erdogan University

Brief Summary: The investigators studied the efficiency of Macintosh laryngoscope and the King Vision video laryngoscope in adult patients scheduled for general anesthesia. Best Cormack-Lehane score obtained, glottic view time, intubation time, time to ventilation, correlation between the Mallampati classification and the Cormack-Lehane grades, and complications related to laryngoscopy and intubation has been investigated.

Detailed Description: Securing the airway is essential in general anesthesia. Anesthetic problems related to airway management constitute 17% of closed claims, difficult intubation being the most common one with an occurrence rate of 5%. Problems like delayed intubation, misplaced tracheal tube, or airway trauma are frequently seen in outpatient settings and end up with either death or hypoxic brain damage. Therefore, preoperative visit should include detailed assessment of the airways according to clues of difficult intubation.Several studies compared the King Vision video laryngoscope with other laryngoscopes in manikins simulating difficult airway scenarios, and reported better glottic views. The investigators aimed to study the correlation between the Mallampati classification and the glottic views (Cormack-Lehane grade) obtained with Macintosh laryngoscopy, and the King Vision video laryngoscopy in adult patients scheduled for general anesthesia. Secondary outcomes will be successful intubation rate, time to obtain the best view, time to successful intubation, and complications related to laryngoscopy will be compared.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 388

Inclusion Criteria

scheduled for general anesthesia
age higher than 18 years
age lower than 60 years

Exclusion Criteria

emergency surgery
mouth opening less than 2 cm
American Society of Anesthesiologists (ASA) score higher than 2
oropharyngeal anomaly
glottic or supraglottic mass
history of surgery due to oropharyngeal anomaly, glottic or supraglottic mass

Study & Design

Study Type: INTERVENTIONAL

Study Design: SEQUENTIAL

Arm && Interventions

Group	Intervention	Description
KingVision	Macintosh laryngoscope	Patients scheduled for general anesthesia during the study period, who had been intubated with King Vision videolaryngoscope first and then with Macintosh laryngoscope.
KingVision	King Vision video laryngoscope	Patients scheduled for general anesthesia during the study period, who had been intubated with King Vision videolaryngoscope first and then with Macintosh laryngoscope.
Macintosh	Macintosh laryngoscope	Patients scheduled for general anesthesia during the study period, who had been intubated with Macintosh laryngoscope first and then with KingVision videolaryngoscope.
Macintosh	King Vision video laryngoscope	Patients scheduled for general anesthesia during the study period, who had been intubated with Macintosh laryngoscope first and then with KingVision videolaryngoscope.

Primary Outcome Measures

Name	Time	Method
Intubation Success Rate	less than 24 hours	Endotracheal intubation attempt is defined as entrance of the endotracheal tube into the patient's mouth. Any major change in the alignment of the laryngoscope is defined as another intubation attempt. Successful endotracheal intubation is defined as the endotracheal cuff passing through the patient's vocal cords. Intubation success rate is defined as: 1 / \[the number of attempts\].

Secondary Outcome Measures

Name	Time	Method
Cormack-Lehane Score	less than 24 hours	Best Cormack-Lehane score (as declared by the laryngoscopist) obtained with both laryngoscopes is recorded. Cormack-Lehane score is graded according to the following criteria (1 is best, and 4 is worst): 1. full view of glottis (difficult intubation unlikely) 2. partial view of glottis (\~5% risk of difficult intubation) 3. partial view of epiglottis, none of glottis seen (\~90% risk of difficult intubation) 4. neither glottis nor epiglottis seen (difficult intubation very likely)
Intubation Time	less than 24 hours	Successful endotracheal intubation is defined as the endotracheal cuff passing the patient's vocal cords. Time to intubation with each laryngoscope is recorded.
Glottic View Time	less than 24 hours	Glottic view time (as defined when the laryngoscopist declared the best Cormack-Lehane score) with each laryngoscope is recorded. Cormack-Lehane score is obtained by directly assessing the distance between the base of the tongue and the roof of the mouth to predict how difficult an intubation will be. It consists of 4 grades: 1. full view of glottis (difficult intubation unlikely) 2. partial view of glottis (\~5% risk of difficult intubation) 3. partial view of epiglottis, none of glottis seen (\~90% risk of difficult intubation) 4. neither glottis nor epiglottis seen (difficult intubation very likely)
Airway Complications	The participants' will be followed for the duration of hospital stay, an expected average of 2 days	Any complication related to the laryngoscopy and intubation, such as cut, bleeding, damage to the teeth, laryngospasm, bronchospasm, desaturation below 90%, is recorded.