General Anesthesia
Conditions
Keywords
Intubation, light wand, video laryngoscopy, cervical spine immobilization
Brief summary
Among advanced intubation equipment for difficult intubation, a lighted stylet (lightwand) is a widely used equipment in cervical immobilized patients. However, a lightwand, which is used blind, is difficult to make midline positioning and can increase airway complications and hemodynamic changes. In contrast, videolaryngoscope can view vocal cord indirectly through camera, however, it requires cervical movement. Therefore, investigator hypothesized that the combined use of video-laryngoscope and lightwand for intubation can improve the efficacy of intubation compared to the use of lightwand alone in cervical immobilized patients.
Interventions
DEVICEVideo-laryngoscope guided lightwand
After anesthetic induction,the difficult airway is simulated by wearing a semi-hard neck collar. For intubation, video-laryngoscope is inserted into the oral cavity ntil the epiglottis tip was visible without lifting the epiglottic vallecula. Then, the endotracheal tube with lightwand is inserted toward the midline under the epiglottis and the intubation is performed looking the transilluminated light of lightwand.
DEVICElightwand alone
After anesthetic induction,the difficult airway is simulated by wearing a semi-hard neck collar. Then, the endotracheal tube with lightwand is inserted and the intubation is performed with conventional method (blind technique by confirming transillumination).
Sponsors
Yonsei University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
1. Aged between 20- 80 yrs 2. Patients scheduled surgery under the general anesthesia
Exclusion criteria
1. Patient who has history of gastro-esophageal reflux disease, previous airway surgery, anatomical abnormality in the upper airway, or coagulopathy 2. Patients with body mass index \>35kg/m2, hemodynamic instability or loosening teeth 3. Patient who disagrees to participate this study or lacks decision-making ability, illiteracy, or foreigner 4. American Society of Anesthesiologists physical status ≥ 3
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The success rate of intubation | Within 90 sec after insertion of lightwand or video-laryngosocpe into oral cavity. | Confirm the success intubation through end-tidal carbon dioxide on a capnography |
| The duration of intubation | Within 90 sec after insertion of lightwand or video-laryngosocpe into oral cavity. | Define as the duration between insertion of lightwand or video-laryngoscope to oral cavity and removal all intubating devices from oral cavity. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Injuries of oral cavity | at immediate after intubation and extubation | Check any blood in lips, teeth, endotracheal cuff, and oral cavity |
| Postoperative hoarseness | at 1hr after PACU arrival and 24hr after operation | Check Yes or No through questioning the patient |
| number of intubation trial and scooping movements | during intubation time, intubation attempts allows maximum 3 times, within 90 sec in each time | The number of intubation tiral and scooping movements during intubation |
| Heart rate change | from start of intubation to 5minute after intubation | The difference between maximum heart rate and minimum minimum heart rate |
| Postoperative sore throat | at 1hr after PACU arrival and 24hr after operation | Check using visual analog scale (0-100 points) |
| Blood pressure change | from start of intubation to 5minute after intubation | The difference between maximum mean blood pressure and minimum blood pressure |
Countries
South Korea
Outcome results
None listed