Cervical Spine Surgery
Conditions
Brief summary
To evaluate the success rate for intubation of laryngocope assisted lightwand intubation.
Detailed description
Light wand intubation is well known for safety intubation in cervical injury patiets. Traditional method of using light wand can damage the supraglottic cavity by scooping the apparatus. The investigators try to evaluate the efficacy of laryngoscope assisted light wand intubation compared to traditional method of using light wand alone.
Interventions
PROCEDURELaryngoscope assisted lightwand intubation
After standard monitoring(EKG, pulse oximetry, NIBP), participants were induced with remifentanil and propofol continuous infusion, using targe-controlled infusion device with prexoygenation with 100% oxygen. Manual in-line stabilization was applied with velcro during intubation to maintain neutral head position. The Macintosh laryngoscope (female: 3rd blade, male: 4th blade) was inserted into the oral cavity to provide direct view of the epiglottis and then the tip of the lightwand was placed below the epiglottis.
PROCEDURELightwand intubation
After standard monitoring(EKG, pulse oximetry, NIBP), participants were induced with remifentanil and propofol continuous infusion, using targe-controlled infusion device with prexoygenation with 100% oxygen. Manual in-line stabilization was applied with velcro during intubation to maintain neutral head position. After 2min from administration of rocuronium, the clinician holds the wand similar to a pencil, stands directly behind the patient's head, inserts the device into the side of the mouth and sweeps the tip to the midline. After confirmation of precise location via clear light source on anterior neck, endotracheal tube was inserted and withdrawn lightwand.
Sponsors
Seoul National University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Patient scheduled for cervical spine surgery under general anesthesia
Exclusion criteria
* congenital or acquired abnormalities of the upper airway, tumours, polyps, trauma, abscesses, inflammation, or foreign bodies in the upper airway * history of gastro-esophageal reflux disease, previous airway surgery, an increased risk of aspiration, coagulation disorders * American Society of Anesthesiologists physical status ≥ 3
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The success rate of intubation | up to 60 seconds | confirm the success intubation via end tidal CO2 measurement |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| lightwand search (=intubation) time | from the insertion of the lightwand or laryngoscope into the oral cavity to the point of transillumination over the cricothyroid membrane within 60 sec. | Check the time(sec) from insertion of the lightwand or laryngoscopy into the oral cavity to push the endotracheal tube into the trachea. |
| The times of scooping of lightwand | within 1min after insertion of lightwand | Within 1min after insertion of lightwand into oral cavity, check the scooping time of lightwand during intubation. |
Other
| Measure | Time frame | Description |
|---|---|---|
| score of postoperative sorethroat | at postanesthetic care unit (PACU) within 1hr after end of anesthesia | check the postoperative sorethroat at PACU in each patient. Numeric rating scale(NRS) was used to measure the severity of pain 0 to 10. |
| Incidence of moderate to severe postoperative sorethroat | at postanesthetic care unit (PACU) within 1hr after end of anesthesia | check the postoperative sorethroat \>3 at PACU in each patient. Numeric rating scale(NRS) was used to measure the severity of pain 0 to 10. 0-3 : mild 4-7 : moderate 8-10 : severe |
| other possible postoperative complications | just after extubation, an expected average of 1hr | tinged blood to endotracheal tube or in oral cavity. hoarseness |
Countries
South Korea
Contacts
Primary ContactHee-Pyung Park, MD PhD
Backup ContactEugene Kim, MD
Outcome results
None listed