Orthosis
Conditions
Keywords
cervical collar, nasoendotracheal intubation, glidescope
Brief summary
Effect of semirigid cervical collar during nasotracheal intubation by Glidescope in the elective cervical spinal surgical patients: a study of clinical predictors and outcomes
Detailed description
Clinically used cervical orthoses can effectively limit cervical spine motion in all direction and provide protection. Among them, the restriction by Miami semirigid collar was superior, with the least tissue-interface pressure of neck. It is one of the most used semirigid collars for patients' protection in the operating theatre. However, the presence of the semirigid collar was shown to result in a poorer view at laryngoscopy, possibly due to a reduction in mouth opening. Nasotracheal intubation is sometimes applied in cervical spinal surgeries for those receiving anterior approach for a higher cervical spine (C3) level, and/ or combined with a short neck, or due to surgeon's preference. Glidescope minimizes cervical movements during laryngoscopy, facilitates nasotracheal intubation than direct laryngoscopy and requires less technical skill than fiberoptic tracheal intubation. The investigation was to assess the effect of cervical collar on nasotracheal intubation and potential hazard factors of prolonged time for nasotracheal intubation with Gildescope in patients scheduled for elective cervical spinal surgery.
Interventions
DEVICEMiami cervical collar
Collar group is put on the Miami cervical collar.
Sponsors
Taipei Veterans General Hospital, Taiwan
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Outcomes Assessor)
Masking description
The anesthetic induction and nasotracheal induction are performed by one anesthesiologist. Another anesthesiology calculated the intubation time according to the video recording.
Intervention model description
The patients are randomized into one of the two group: the collar group or the non-collar group before anesthetic induction. In the collar group, the patient was put on a Miami cervical collar and then anesthetic induction and nasotracheal intubation are performed. the non-collar group receive the same anesthetic care without a collar as a control.
Eligibility
Sex/Gender
ALL
Age
20 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* elective cervical spine surgery * scheduled for nasotracheal intubation * not requiring orthosis for prophylactic protection
Exclusion criteria
* Risk of pulmonary aspiration of gastric contents * Pathology of the nasal cavity * Abnormal coagulation function * Extensive and severe cord compression * Refused to sign informed consent.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Nasointubation Time | Intraoperative | intubation time assisted by Glidescope |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| subjective scoring of ease of intubation | Intraoperative | ease of intubation scored with visual analogue scale |
| magill forceps for nasointubation | Intraoperative | whether magill forcepts is required to facilitate nasointubation |
Countries
Taiwan
Outcome results
None listed