Spinal Injuries
Conditions
Keywords
intubation, difficult airway, fiberscopy, Airtraq, general anesthesia
Brief summary
Patients who present with an unstable cervical spine following an accident need a general anesthesia for the necessary surgery. Commonly, the management of the tracheal intubation is performed by a fiberoptic technique. However, changes in equipment availability and quality may challenge the fiberoptic intubation technique. The investigators wish to compare the tracheal intubations performed with the Airtraq in comparison with the fiberscopic technique.
Detailed description
Patients who present with an unstable cervical spine following an accident need a general anesthesia for the necessary surgery. Commonly, the management of the tracheal intubation is performed by a fiberoptic technique (historic gold standard technique). However, changes in equipment availability and quality may challenge the fiberoptic intubation technique. We wish to compare the tracheal intubations performed with the Airtraq in comparison with the fiberscopic technique. Primary outcomes will be the changes in neurophysiologic responses monitored by a neurophysiologist in 5 specific phases: 1. Basal potential (BM): neuromonitoring while the patient is anesthetized, no movements 2. Ventilation potential (VM): neuromonitoring while the patient is anesthetized and a bag-mask ventilation is performed 3. Intubation potential (IP): neuromonitoring while the patient is being intubated with one of the two randomized devices 4. Post Intubation (PI): neuromonitoring after the patient has been intubated 5. Post Positioning (PP): neuromonitoring after the patient has been properly positioned on the operating table and is ready for surgery
Interventions
PROCEDUREtracheal intubation
tracheal intubation with the Airtraq
DEVICEAirtraq
DEVICEfiberscope
Sponsors
University of Lausanne Hospitals
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* unstable cervical spine due to a cervical vertebra fracture * American Society of Anesthesia classification 1-3 * BMI \< 30 kg/m2 * patients necessitating a general anesthesia for surgery
Exclusion criteria
* patient refusal * ASA \>3 * mouth opening \< 15mm * patients with known history of previous orotracheal tumor surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Neuromonitoring modifications (modifications appearing on the neuromonitoring) | 30 seconds | modifications appearing on the neuromonitoring during the 5 different phases |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| time necessary for tracheal intubation | 180 seconds | — |
| tracheal inlet view (best view during intubation) | 10 seconds | best view during intubation |
| number of attempts necessary | 180 seconds | — |
Countries
Switzerland
Outcome results
None listed