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Discomfort in Upper Airways Due to intubation-a Randomized Controlled Trial

Not Applicable
Recruiting
Conditions
Intubation Complication
Intubation; Difficult or Failed
Postoperative Complications
Interventions
Registration Number
NCT05614609
Lead Sponsor
Ostfold University College
Brief Summary

Few studies have compared different methods for optimalizing intubation conditions in general anesthesia. This randomized controlled trial will compare two different methods for intubation in general anesthesia in gastro- or gynecological procedures.

Detailed Description

In general anesthesia, it is neccessary to secure the airways with an endotracheal tube. There is no international consensus on how intubation is most efficiently conducted. A cochrane review compared using muscular relaxing medication versus not using blocks for intubation. Primary outcomes were intubation conditions and discomfort in upper airways. The authors concluded that research is limited, and that further research is needed. No studies have compared local anesthetic spray on the glottis and muscular relaxing medication in intubation, focusing on discomfort in upper airways. The null-hypothesis of this study is that there is no difference in upper airway discomfort when using local anesthetic spray or muscular relaxing medication. The study will have a randomized controlled design, randomizing patients undergoing gastro- or gynecological procedures in general anesthesia to receiving either rocuronium (muscle relaxing medication) intravenous, or lidocain spray on the glottis before intubation. The primary outcome is postoperativ hoarseness one hour after intubation.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
120
Inclusion Criteria
  • ASA (American Association of Anesthesiologists Classification system for physical status) I-III
  • Understand and can express themselves in Norwegian
  • Able to give informed consent to participate
Exclusion Criteria
  • Cave lidocain and/or muscle relaxing medication
  • BMI above 40
  • Anticipated difficult intubation
  • Need for ventricular tube
  • Pathology or malformations in upper airways

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Lidocaine spray on the glottisLidocaine topicalLidocaine 20 mgl/ml- 4,4 ml will be sprayed on the glottis. Ventilation for 90 sek, intubation
Muscle relaxing medicationLidocaine topicalRocuronium 0,6 mg/kg administered intravenous. Ventilation for 2.5 minutes (150seconds), intubation
Primary Outcome Measures
NameTimeMethod
Degree of hoarseness 1 hour after extubation1 hours

Scored on a scale : 0=no, 1= self reported hoarseness, 2=observed hoarsness by care personnel, 3=aphonia

Secondary Outcome Measures
NameTimeMethod
Proportion of patients who cough on tube at extubationAt extubation

yes/no

Number of patients needing extra equipment for intubatingAt intubation

bourgie, c-mac, other

Proportion of patients who cough when sprayingAt intubation

yes/no

Intubation conditionsBefore intubation

Cormack \& Lehane four degrees

Number of intubation attemptsAt intubation

Number

Proportion of patients with normal anatomy in upper airwaysAt intubation

yes/no

Heart rate changes during intubationat intubation

Heart rate before and 2 minutes after intubation

Proportion of patients with blood on tube after extubationAt extubation

yes/no

Blood pressure changes during intubationat intubation

Blood pressure before and 2 minutes after intubation

Degree of hoarsness 24 and 48 hours after extubation2-48 hours

Scored on a scale : 0=no, 1= self reported hoarseness, 2=observed hoarsness by care personnel, 3=aphonia

Proportion of patients reporting different degrees of sore throat at 2, 24 and 48 hours after extubation2-48 hours

0=no, 1=mild, 2=moderate, constant pain when swallowing, 3=severe pain needing analgesia

Trial Locations

Locations (1)

Ann-Chatrin Linqvist Leonardsen

🇳🇴

Kråkerøy, Østfold, Norway

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