COMPARISON BETWEEN C MAC VIDEO LARYNGOSCOPE AND TUOREN VIDEO LARYNGOSCOPE FOR ENDOTRACHEAL INTUBATION IN PEDIATRIC POPULATION UNDERGOING GENERAL ANAESTHESIA

Completed

Conditions: Medical and Surgical,

Registration Number: CTRI/2021/04/033279

Lead Sponsor: Maulana Azad Medical College

Brief Summary: The pediatric airway management poses a challenge to anaesthesiologists across the globe due to the major anatomical, physiological and developmental differences in them as compared to the adult population. One of the prime causes of anaesthetic morbidity and mortality is complications arising from difficult tracheal intubation despite recent evolution in airway management strategies. Direct laryngoscopy (DL) has been regarded as the gold standard for endotracheal intubation (ETI) in both paediatric and adult patients. Direct laryngoscopy guided tracheal intubation requires the three axes (oral, pharyngeal and laryngeal) to be arranged in one straight line, achieved by placing the head and neck in the sniffing position. Up to 4.7% of paediatric patients undergoing general anaesthesia (GA) may present with difficult intubation. Hence, one has to be equipped to manage a situation of difficult airway at all times.

In an attempt to reduce the morbidity and mortality associated with difficult airway, several video laryngoscopes (VLs) such as Glidescope, Truview, Airtraq and C-MAC have been introduced into clinical practice. These video laryngoscopes ensure a better glottic view, with greater intubation success and reduced complications as compared to the conventional direct laryngoscopy in the adult population, and are being increasingly used in the paediatric population. Flexible fiberoptic bronchoscopes are used in difficult pediatric airway, but are technically more challenging than the video laryngoscopes.

The C-MAC VL is a fourth generation VL, with a standard Miller/Macintosh blade with a distal camera at two-thirds of its length. It has been successfully used for visualization of the larynx in various difficult airway cases.It is available in the Macintosh blade sizes (sizes 2, 3, and 4) and pediatric Miller sizes (sizes 0 and 1). It also has a D- blade for difficult airways.

Tuoren is a newer video laryngoscope, which has advantages of disposable blades, large screen size, anti-fogging feature and a longer battery life, in addition to being portable and cost effective. It has a blade that has retained the shape and curvature of Macintosh blade. The reusable laryngoscope handle is fully compatible with 6 size of blades: Mac2/Mac3/Mac4/MIL00/MIL0/MIL1.

Hence, in this randomized comparative study, we aim to compare C Mac and Tuoren video laryngoscope guided endotracheal intubation using micro-cuffed endotracheal tube in paediatric patients undergoing elective surgery under general anaesthesia.

Detailed Description: Not available

Recruitment & Eligibility

Status: Completed

Sex: All

Target Recruitment: 40

Inclusion Criteria

Patients belonging to American Society of Anaesthesiologists (ASA) Physical Grade I and II undergoing elective surgery under general anaesthesia requiring endotracheal intubation.

Exclusion Criteria

Patients with mouth opening less than or equal to 2.5 cm 2.
Patients belonging to Modified Mallampati class III and IV 3.
Patients with predicted difficult airway (anatomical deformity of head and neck, fracture of maxillofacial region or tumors of oral cavity).

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Intubation Difficulty Scale (IDS) score, consisting of seven parameters	During laryngoscopy and endotracheal intubation

Secondary Outcome Measures

Name	Time	Method
Time taken to intubate	Between blade entry past the lips and the appearance of first square wave capnograph
Intraoperative hemodynamic response measured by:	1.Heart rate trend in the intraoperative period
Complications including:	1. Blood staining on the device or tracheal tube

Trial Locations

Locations (1): Lok Nayak Hospital
🇮🇳
Central, DELHI, India
Lok Nayak Hospital
🇮🇳Central, DELHI, India
Dr Ashika Johney
Principal investigator
9310138509
ashika.johney@gmail.com