Role of Ultrasonography in Airway Management

• Conditions: Obese Patients

• Registration Number: NCT04140357
• Lead Sponsor: Diskapi Yildirim Beyazit Education and Research Hospital

Brief Summary

Ultrasound is one of the most useful devices in daily anesthesia practice. Latest purpose of ultrasound usage is prediction of difficult intubation. In this study, we aimed to predict difficult laryngoscopy and intubation by using ultrasound measurement of neck soft tissue thickness in obese patient preoperatively.

Detailed Description

In this prospective and randomized controlled study, mallampati scores, interincisor gap, thyromental distance, neck circumference measurement and upper lip bite test scores will be recorded in sixty obese patients.

Additionally, neck tissue thickness will be recorded at 4 different levels (hyoid bone-skin distance, epiglot-skin distance , thyroid istmus-skin distance, vocal cord-skin distance) after the sniffing position by ultrasound with the linear probe. All measurements will be repeated three times and an average values will be recorded.

After all this measurements, endotracheal intubation will be performed by an experienced anesthetist who is uninformed about study. During intubation the Cormack Lehane (C/L, grade 1: full view of the vocal cords; grade 2a: partial view of the glottis; 2b: posterior part of the vocal cord and arytenoids visible; grade 3: only epiglottis visible; and grade 4: neither epiglottis nor glottis visible) and the Intubation Difficulty Scale (IDS) score (the numbers of attempts, operators, and alternative techniques used, the C/L grade of laryngoscopic view, lifting force and external laryngeal manipulation required, and position of the vocal cords. Every insertion of the laryngoscope and advancement of the tracheal tube towards the glottis counted as an attempt. A score of \>5 indicates moderate-to-major difficulty) will be recorded.

Study Timeline

• Status Verified: 2019-10
• Study First Submitted: 2019-10-16
• Study First Submitted QC: 2019-10-24
• Last Update Submitted: 2019-10-24
• Study First Posted: 2019-10-25
• Last Update Posted: 2019-10-25
• Study Start: 2019-11-01
• Primary Completion: 2020-03-01
• Study Completion: 2020-03-01

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

• BMI>30
• 18-65 YEARS
• ASA 1-2-3
• Obese patients

Exclusion Criteria

• Pregnancy
• Upper airway pathology
• Cervical spine pathology
• Laryngeal pathology

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Thyroid isthmus-skin distance	30 minutes before induction	The thyroid isthmus-skin distance will be measured by using ultrasound in centimeters
Epiglottis-skin distance	30 minutes before induction	The epiglottis-skin distance will be measured by using ultrasound in centimeters
Vocal cord-skin distance	30 minutes before induction	The vocal cord-skin distance will be measured by using ultrasound in centimeters
Hyoid bone-skin distance -effect of ultrasound on prediction of difficult laryngoscopy	30 minutes before induction	The hyoid bone-skin distance will be measured by using ultrasound in centimeters

Secondary Outcome Measures

Name	Time	Method
Intubation difficulty scale score	1 minutes after intubation	Each number of numbers attempt, operator and alternative techniques used, the Cormack Lehane score of laryngoscopic view, lifting force and external laryngeal manipulation required, and position of the vocal cords count 1 point. A score of \>5 indicates moderate-to-major difficulty

Trial Locations

Locations (1)

Başak Gülel; 🇹🇷 Ankara, Province, Turkey