Anaesthesia
Conditions
Keywords
tracheal intubation
Brief summary
The Airtraq is a battery powered single use optical laryngoscope with a channel to hold and guide the tracheal tube into the trachea. It enables tracheal intubation in patients with normal and difficult airways, by enabling laryngoscopy without neck movement. As a single use device, it is cost effective to have these placed in emergency equipment kits, and for use by emergency and military personnel. However, it does have several limitations. The Airtraq requires the user to place his/her eye to the eyepiece in order to see the advancement of the laryngoscope and the tracheal tube, which may be difficult if the patient is on the ground or in emergency scenarios. Only the user can see through the eyepiece and any assistants are unable to view the larynx, this makes it difficult for assistants to help the operator. Many handphones now incorporate high quality cameras. In this study, we will evaluate the effectiveness of using the iPhone to aid laryngoscopy with the Airtraq optical laryngoscope during laryngoscopy and intubation in 30 patients presenting for elective surgery under general anaesthesia. We have manufactured an attachment that fits over the eyepiece of the Airtraq, to hold an iPhone to the eyepiece. This will enable to operator and assistants to simultaneously view the insertion of the Airtraq, view the larynx and view the passage of the tracheal tube into the trachea.
Detailed description
This study is a single-cohort study design. 30 patients undergoing elective surgery under general anaesthesia will be recruited. They will have endotracheal intubation done with the Airtraq optical laryngoscope and handphone camera assisted visualization. The Airtraq optical laryngoscope fitted with the attachment holding the camera handphone will be prepared and loaded with an appropriately sized endotracheal tube. A standard general anaesthesia technique will be used. This will include standard monitoring including pulse oximetry, non-invasive blood pressure, ECG and capnography, all started before induction of anaesthesia. Anaesthesia will be induced with proprofol and fentanyl, and muscle relaxation with atracurium. The airway management procedure will start after induction of anaesthesia and muscle relaxation. The Airtraq optical laryngoscope will be used. The Airtraq is fit with an attachment to hold the camera handphone, and loaded with an endotracheal tube. The Airtraq will be inserted and manipulated until the best view of the patient's laryngeal opening can be seen on the camera handphone screen. The endotracheal tube will then be placed in the patient's trachea and the cuff inflated. Successful intubation will be confirmed by 3-point auscultation and presence of end-tidal carbon dioxide tracing.
Interventions
DEVICEAirtraq visualization
Larynx visualization with Airtraq and attached handphone
Sponsors
National University Hospital, Singapore
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
21 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
Adult patients requiring general anaesthesia for elective surgery and who require tracheal intubation as part of the anaesthesia technique. American Society of Anesthesiologists Class I to III physiological status.
Exclusion criteria
Children Pregnant patients Patients who have not fasted for at least 6 hours pre surgery Patients at risk of regurgitation and aspiration
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visualization of Larynx With the Airtraq Laryngoscope and Handphone | Intra operative | The efficacy of viewing the larynx via the handphone attached to the Airtraq laryngoscope will be assessed. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Transmission of Airtraq View of Larynx | Intra operative measurement, time frame within 5 minutes | The view of the larynx will be captured by the handphone attached to the Airtraq layryngoscope, and then transmitted to a second investigator. |
Countries
Singapore
Participant flow
Recruitment details
Recruitment from 16 July 2014 to 27 July 2015, in hospital ward, before surgery and anesthesia.
Participants by arm
| Arm | Count |
|---|---|
| Airtraq Visualization Larynx visualization with Airtraq and attached handphone
Airtraq visualization: Larynx visualization with Airtraq and attached handphone | 30 |
| Total | 30 |
Baseline characteristics
| Characteristic | Airtraq Visualization |
|---|---|
| Age, Categorical <=18 years | 0 Participants |
| Age, Categorical >=65 years | 4 Participants |
| Age, Categorical Between 18 and 65 years | 26 Participants |
| Age, Continuous | 40 years STANDARD_DEVIATION 16.2 |
| Region of Enrollment Singapore | 30 participants |
| Sex: Female, Male Female | 18 Participants |
| Sex: Female, Male Male | 12 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 0 / 30 |
| serious Total, serious adverse events | 0 / 30 |
Outcome results
Primary
Visualization of Larynx With the Airtraq Laryngoscope and Handphone
The efficacy of viewing the larynx via the handphone attached to the Airtraq laryngoscope will be assessed.
Time frame: Intra operative
Population: Study participants in whom the Airtraq handphone visualization system was studied
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Airtraq Visualization | Visualization of Larynx With the Airtraq Laryngoscope and Handphone | 30 participants |
Secondary
Transmission of Airtraq View of Larynx
The view of the larynx will be captured by the handphone attached to the Airtraq layryngoscope, and then transmitted to a second investigator.
Time frame: Intra operative measurement, time frame within 5 minutes
Population: The larynx could be visualized in all 30 patients using the handphone attached to the Airtraq. The images of the larynx could be transmitted to a remote assistant in all 30 patients.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Airtraq Visualization | Transmission of Airtraq View of Larynx | 30 participants |