Comparison of the Glidescope and Macintosh Laryngoscope for Double Lumen Endotracheal Tube Intubation
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 70
- 试验地点
- 1
- 主要终点
- Time to intubation (laryngoscope or DLT inserted between patient's lips to DLT placement in the trachea and laryngoscope withdrawal)
研究概览
简要总结
Patients undergoing chest surgery often require insertion of a breathing tube (double lumen tube) after they are unconscious. The double lumen tube enables the anaesthetist to ventilate (assist breathing) one lung at a time. The other lung is partially deflated to enable enough space for the surgeon to perform the procedure. The breathing tube is inserted with a laryngoscope (blade with a light at the end) so the vocal cords can be seen. This is standard medical practise. Two laryngoscopes are commonly used at Toronto General Hospital to insert the tube. The Macintosh laryngoscope has been is use for over 50 years and the Glidescope for over 10 years. Both devices have been extensively researched for single lumen tubes insertion and found to be very safe and effective. Research is limited to say which of the two laryngoscope is the most effective for double lumen tubes.
详细描述
The Glidescope (GVL) has been extensively studied for single lumen tube intubation and found to be a very safe and useful device. It is a particularly useful for patients with difficult airways as it has a camera attached to the blade. Despite being used for double lumen tube (DLT) intubations, research of its effectiveness and safety, is lacking. The study aims to determine the speed and safety of the GVL for DLT insertion. This information will assist anaesthetists in choosing the appropriate laryngoscope for DLT intubation of their patients.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Population: planned elective lung surgery requiring general anaesthesia with a double lumen endotracheal intubation, signed informed patient consent.
排除标准
- •Previous failed intubation,
- •history of difficult intubation or anticipated difficult intubation (2 risk factors of mallampati score 3 or greater,
- •incisor gap < 3.5cm, thyromental distance < 6.5cm,
- •reduced neck extension and flexion),
- •alternative method of intubation indicated eg rapid sequence intubation,
- •fibreoptic intubation,
- •contra-indication to a left double lumen tube eg endobronchial tumor,
- •significant deviation or compression of the trachea and bronchi.,
- •contraindication to one lung ventilation eg severe hypoxia or pulmonary hypertension,
- •anticipated difficult bag mask ventilation,
- •symptomatic gastro-oesophageal reflux,
- •oral/pharyngeal/laryngeal carcinoma,
- •loose teeth,
- •allergy to rocuronium, BMI > 40.
研究组 & 干预措施
The GlideScope (GVL)
干预措施: GlideScope (GVL) (Device)
Macintosh direct laryngoscope (MDL)
干预措施: Macintosh Direct Laryngoscope (MDL) (Device)
结局指标
主要结局
Time to intubation (laryngoscope or DLT inserted between patient's lips to DLT placement in the trachea and laryngoscope withdrawal)
时间窗: Number of minutes (0-2) that is required to intubate will be recorded, if a 2nd attempt is required, duration to successfull intubation will be recorded in minutes.
Patients will be randomized to either MDL or GVL. If the first attempt fails to intubate within 2 minutes the anesthetist will remove the laryngoscope and provide mask ventilation. The second intubation attempt the anesthetist is encouraged to use the same randomized laryngoscope however, if the treating anesthetist feels a different device and technique will have a higher success rate they can perform that technique on the second attempt regardless of the randomized device. Anesthetists will complete a questionnaire after intubation.
次要结局
- Time to lung isolation, difficulty of the procedure, complication to the patients(From the beginning of the operative procedure through to 24 hours postoperatively)