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Comparing the "Snifing Position" , "Simple Head Extension" and "Neutral Position"

Not Applicable
Completed
Conditions
Therapeutic Procedural Complication
Interventions
Other: Head position
Registration Number
NCT05331287
Lead Sponsor
The First Hospital of Qinhuangdao
Brief Summary

The simple head extension is recommended for optimization of glottic visualization during Nasotracheal intubation via fiberoptic bronchoscope (FOB) . However, no study confirmed its superiority over"snifing position" and "Neutral Position". In a prospective, randomized study, the authors compared the snifing position , simple head extension and "Neutral Position" in Nasotracheal intubation via fiberoptic bronchoscope.

Detailed Description

The study included ninety patients with anticipated difficult airways. The snifing position was obtained by placement of a 7-cm cushion under the head of the patient; the extension head position was obtained by placement of a 7-cm cushion under the shoulder; the neutral position with the occiput close to the operating table. The head position was randomized as follows: neutral position group (NP group), sniffing position group (SP group) or extension position group (EP group). Randomization (1:1:1) was based on the codes generated by Excel software, which were kept in sequentially numbered opaque envelopes until the began of study.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
60
Inclusion Criteria

• ASA classifications of I-II, modified Mallampati classification of 3 or 4, requiring general anesthesia were included.

Exclusion Criteria
  • • ASA class IV or V

    • Abnormalities of the heart, brain, liver, lung, kidney and coagulation functions

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
neutral positionHead positionNasotracheal intubation via fiberoptic bronchoscope under snifing position.The Head Extension was obtained by the occiput of the patient close to the operating table. When the FOB was inserted into Nasal cavity, and the epiglottis and glottis were identified by the FOB. The anterior of FOB was inserted deep into tracheal after the glottis was exposed sufficiently then the tracheal tube was pushed into the trachea via the FOB.
snifing PositionHead positionNasotracheal intubation via fiberoptic bronchoscope under snifing position.The snifing position was obtained by placement of a 7-cm cushion under the head of the patient. When the FOB was inserted into Nasal cavity, and the epiglottis and glottis were identified by the FOB. The anterior of FOB was inserted deep into tracheal after the glottis was exposed sufficiently then the tracheal tube was pushed into the trachea via the FOB.
Head ExtensionHead positionNasotracheal intubation via fiberoptic bronchoscope under snifing position.The extension position with a 7-cm pillow underneath the shoulder and the occiput close to the operating table. When the FOB was inserted into Nasal cavity, and the epiglottis and glottis were identified by the FOB. The anterior of FOB was inserted deep into tracheal after the glottis was exposed sufficiently then the tracheal tube was pushed into the trachea via the FOB.
Primary Outcome Measures
NameTimeMethod
Intubation TimeTen minutes

The primary endpoints were the time to view the vocal cords (TVC) which was taken when the operator indicated verbally that he view the vocal cords and the time to successful tracheal intubation (TSI). TSI was defined as the time taken from insertion of the FOB between the teeth until the appearance of a capnograhy curve.

Secondary Outcome Measures
NameTimeMethod
Occurrence of throat pain measured by VASone day Postoperative]

Trial Locations

Locations (1)

The first hospital of Qinhuangdao

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Qinhuangdao, Hebei, China

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