Comparison Between Rigid Video Assisted Laryngoscopy vs Flexible Laryngoscopy in Anticipated Difficult Intubation
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 106
- 主要终点
- Intubation time
研究概览
简要总结
This is a randomized control study where adult patients had been divided randomly into two equal groups using video laryngoscope in group (V) and flexible intubating laryngoscope in group (F)
详细描述
Routine pre-operative assessment including history taking, clinical examination, and laboratory tests. Patients were admitted to the operating room with a small 20G IV cannula after applying inclusion & exclusion criteria and airway assessment by applying El Ganzuri multivariate risk index for difficult intubation which include assessment of the following : inter-incisor gap, Mallampati classification, head &neck movement, buck teeth prognathism, thyromental distance, body weight and history of difficult intubation.
Operating room was prepared using :
Difficult airway cart that includes different size oral airways, endotracheal tubes, different sizes face masks & laryngeal airway masks Suction apparatus to be ready for use Video laryngoscopy The flexible intubating laryngoscopy with the tube mounted over the fiberscope before the procedure.
Standard monitoring devices were applied including ECG, non invasive blood pressure. pulse oximetry and capnography after intubation Patients were then pre-oxygenated via face mask for three minutes and using 0.01 mic/kg atropine then general anesthesia is induced using fentanyl 1-2 mic/kg followed by propofol 2 mg/kg and esmeron 0.5 mg/kg.
The patient is mechanically ventilated using face mask until full relaxation is established after 3-5 minutes. The intubation is done using video laryngoscope in group (v) or using flexible intubating laryngoscopy in group (f) In the first group (v) The video laryngoscope was introduced with the patient appropriately positioned, the operator used the left hand to introduce the video laryngoscope into the midline of the Oropharynx and gently advances until the blade tip pass the posterior portion of the tongue. Using video visualization, the ETT was then advanced on a smooth curve through the glottis and intubation proceeds. Viewing the entire insertion step on the video screen allows the operator to quickly become facile with the motion of gently rotating or angling the tube using the right hand to redirect as necessary.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
盲法说明
the participant does not know which group the patient belongs to as every patient was consented for both devices which were ready in the operating theatre
入排标准
- 年龄范围
- 20 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •El-Ganzouri score: 2, 3, 4 (Table 1)
- •American Society of Anesthesiology (ASA) I, II, III
- •Elective surgeries
排除标准
- •Refusal of participation
- •Patients who need a surgical airway (e.g. patients with highly obstructing laryngeal lesions such as cancer tongue, larynx& maxilla).
- •Patients with laryngeal trauma, especially in those with suspected cricotracheal separation.
- •Patients with craniofacial trauma.
结局指标
主要结局
Intubation time
时间窗: Through study completion (Assessment done at the same time of doing intubation) within 60 seconds
time from initiation of intubation (application of the laryngoscope into mouth) to ETCO2 detection from the ETT. In cases with failed intubation it was considered from initiationof intubation till failure. Measured by seconds
次要结局
- Heart rate(At the same time of doing the intubation within 15 minutes)
- Incidence of complications(From time of intubation till end of surgery and extubation within 10 hours)
- Number of attempts(AT the same time of doing the intubation within 30 minutes)
- Blood pressure(At the same time of intubation within 15 minutes)