Tracheal Intubation
Conditions
Brief summary
Videolaryngoscopes become widely used. The aim of this study is to compare anesthetic induction when patients are tracheally intubated using a MacGraph Mac videolaryngoscope or a conventional MacIntosh laryngoscope. Tracheal intubation induces a nociceptive stimulation. Hypothesis is that the use of a videolaryngoscope induces a less pronounced nociceptive stimulation and, consequently, that it modifies the anesthetic drugs requirement. .
Detailed description
All patients will received a standardized anesthetic procedure : combined closed-loop anesthesia system using bispectral index as control variable and two proportional-differential control algorithms, a propofol and a remifentanil target-controlled infusion system. The effectiveness of such a closed-loop anesthesia system has been demonstrated in a prospective, randomized study. Patients will be randomized in two groups : intubation using a conventional MacIntosh laryngoscope or intubation using a videolaryngoscope. If our hypothesis is confirmed, the required concentration of remifentanil, an opioid agent, will be reduced in the group using a videolaryngoscope.
Interventions
PROCEDURETracheal intubation
Tracheal intubation will be performed using a Macintosh laryngoscope or a McGrath Mac videolaryngoscope
DRUGPropofol and remifentanil anesthesia
The standardized anesthetic procedure used a closed-loop anesthesia system with bispectral index as control variable and with two proportional-differential control algorithms, one for propofol target-controlled infusion system and one for remifentanil target-controlled infusion system.
Sponsors
Hopital Foch
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* patient scheduled for a general anesthesia with orotracheal intubation
Exclusion criteria
* predictable risk of difficult mask ventilation or of difficult tracheal intubation * necessity of a rapid sequence induction * contra-indication to the use of the automated administration of propofol and of remifentanil * contra-indication to the use of atracurium * Otolaryngology, thoracic surgery, or intracranial surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Required dose of opioid to counteract nociceptive stimulation | 1 hour | Tracheal intubation induces a nociceptive stimulation. Hypothesis is that the use of a videolaryngoscope induces a less pronounced nociceptive stimulation and, consequently, that the required maximal concentration of remifentanil is lower than when a standard laryngoscope is used. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Characteristics of tracheal intubation | one hour | time to obtain the first capnogram |
| Characteristics of anesthesia | one hour | Peak concentration of propofol |
| Complications of intubation | one day | Throat pain and hoarseness |
| Ergonomic evaluation of the device | one hour | questionnaire Qusi |
Countries
France
Outcome results
None listed