To study the effect of three head positions on ease of placing tube in wind pipe

Not yet recruiting

Conditions: Other specified symptoms and signsinvolving the circulatory and respiratory systems,

Registration Number: CTRI/2020/01/022744

Lead Sponsor: Safdarjung Hospital

Brief Summary: Successful placement of the tracheal tube duringvideolaryngoscopy may depend on head and neck position. Asuboptimal head and neck position may be associated with difficultvideolaryngoscopy and tracheal intubation and repeated attempts at laryngoscopythat can lead to poor outcomes. Videolaryngoscopy involves visualising the vocal cords by means otherthan direct sight. The sniffing position may not be advantageous during performance ofvideolaryngoscopy as it is not necessary to align the three axes to obtainglottis view. Impingement of the tracheal tube on the anteriortracheal wall is one of the factors associated with technical difficultiesduring videolaryngoscopy-guided intubation.

It has been suggested that impingement of the trachealtube on the anterior tracheal wall is more likely to occur in the sniffingposition due to lower cervical spine flexion compared with the neutral orsimple extension position. No significant difference in the ease of intubation was found between thesniffing and the neutral position when using C-MACÂ®videolarygoscope.Head andneck position in supine sniffing position was found to be a predictor ofdifficult videolaryngoscopy compared with supine neutral position.

There is paucity of literatureinvestigating the optimal head and neck position for videolaryngoscopy. The study hypothesis is that the neutralposition would be superior to the sniffing position and the simple extensionposition with regard to ease of intubation while performing C-MACÂ® videolaryngoscopy in adult patients undergoingsurgery under general anaesthesia. The aim of this prospective, randomisedstudy is to determine the differences between the sniffing, neutral and simpleneck extension position with regard to ease of intubation as determined by themodified intubation difficulty scale by videolaryngoscopy in adult patients undergoingelective surgery under general anaesthesia with tracheal intubation. Intubation time, Percentage of glottic opening score, Cormack-Lehane laryngoscopy grade and first attempt success rate will also be compared.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 180

Inclusion Criteria

Patients belonging to American Society of Anesthesiologists physical status I and II, scheduled for elective surgery under general anesthesia with tracheal intubation.

Exclusion Criteria

1.Patients with predicted difficult airway requiring awake tracheal intubation 2.Obvious malformation of the neck or face, known oropharyngeal pathology, unstable cervical spine 3.Patients requiring rapid sequence intubation 4.Pregnancy 5.
BMI > 30 kg/m2.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
To compare the neutral, sniffing and simple extension head position for ease of videolaryngoscopy-guided tracheal intubation using Modified Intubation Difficulty Score in adult patients undergoing elective surgery under general anaesthesia	At the time of videolaryngoscopy and tracheal intubation

Secondary Outcome Measures

Name	Time	Method
1. Intubation time	2. Laryngoscopic view assessed by Cormack and Lehane grading and by Percentage of Glottic Opening (POGO) score

Trial Locations

Locations (1): Safdarjung Hospital
🇮🇳
South, DELHI, India
Safdarjung Hospital
🇮🇳South, DELHI, India
Smita Prakash
Principal investigator
drsunilprakash@gmail.com