Forces on Teeth During Videolaryngoscopy

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-05-31

Study Completion Date

2012-09-30

Brief Summary

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In this randomized crossover trial the investigators test whether three different brands of videolaryngoscopes (VLS) exhibit reduced forces on both upper and lower teeth, and compare them with a classic Macintosh laryngoscope blade.

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Detailed Description

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During endotracheal intubation the anesthesiologist uses a laryngoscope blade to distract the tongue to achieve the best view of the glottis opening, thereby avoiding using the maxillary incisors as a fulcrum to lever the soft tissues upwards. Using the maxillary incisors as a fulcrum may otherwise result in dental trauma. It is obvious that contact with teeth and - even worse - the incidence of accidental dental trauma, is directly related to the difficulty of the intubation.

Indirect videolaryngoscopy has proven advantageous over direct laryngoscopy using a classic Macintosh blade, for improved viewing of the glottis, with subsequent more successful intubations, and a shorter effective airway time both in patients with normal and difficult airways. Previously, it has been demonstrated that the forces exerted by the anesthesiologist on the patient's maxillary incisors are reduced when using a VLS, compared with a classic Macintosh laryngoscope. However, only one type of VLS (V-MAC®, Karl Storz, Tuttlingen, Germany) was used or only forces applied to upper teeth were being registered.

Conditions

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Tooth Injuries Intubation Complication

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Classic Macintosh laryngoscope

Classic Macintosh laryngoscope (Karl Storz, Tuttlingen, Germany)

Group Type OTHER

Forces exerted on teeth during intubation

Intervention Type DEVICE

Anesthesia will be induced in the conventional matter. The classic Macintosh laryngoscope will be placed in the patient's mouth and a tube will be brought into position in front of the glottis. Hereafter, one of the three videolaryngoscopes will be placed in the patient's mouth and the endotracheal tube will be actually passed through the vocal cords. The measurement of forces applied to the teeth will be performed using Flexiforce® sensors.

McGrath®

McGrath® (Aircraft Medical Ltd, Edinburgh, UK)

Group Type OTHER

Forces exerted on teeth during intubation

Intervention Type DEVICE

Anesthesia will be induced in the conventional matter. The classic Macintosh laryngoscope will be placed in the patient's mouth and a tube will be brought into position in front of the glottis. Hereafter, one of the three videolaryngoscopes will be placed in the patient's mouth and the endotracheal tube will be actually passed through the vocal cords. The measurement of forces applied to the teeth will be performed using Flexiforce® sensors.

C-MAC®

C-MAC® (Karl Storz, Tuttlingen, Germany)

Group Type OTHER

Forces exerted on teeth during intubation

Intervention Type DEVICE

Anesthesia will be induced in the conventional matter. The classic Macintosh laryngoscope will be placed in the patient's mouth and a tube will be brought into position in front of the glottis. Hereafter, one of the three videolaryngoscopes will be placed in the patient's mouth and the endotracheal tube will be actually passed through the vocal cords. The measurement of forces applied to the teeth will be performed using Flexiforce® sensors.

GlideScope® Cobalt

GlideScope® Cobalt (Verathon Medical, Bothell, WA, USA)

Group Type OTHER

Forces exerted on teeth during intubation

Intervention Type DEVICE

Anesthesia will be induced in the conventional matter. The classic Macintosh laryngoscope will be placed in the patient's mouth and a tube will be brought into position in front of the glottis. Hereafter, one of the three videolaryngoscopes will be placed in the patient's mouth and the endotracheal tube will be actually passed through the vocal cords. The measurement of forces applied to the teeth will be performed using Flexiforce® sensors.

Interventions

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Forces exerted on teeth during intubation

Anesthesia will be induced in the conventional matter. The classic Macintosh laryngoscope will be placed in the patient's mouth and a tube will be brought into position in front of the glottis. Hereafter, one of the three videolaryngoscopes will be placed in the patient's mouth and the endotracheal tube will be actually passed through the vocal cords. The measurement of forces applied to the teeth will be performed using Flexiforce® sensors.

Intervention Type DEVICE

Other Intervention Names

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Macintosh laryngoscope (Karl Storz, Tuttlingen, Germany) McGrath® (Aircraft Medical Ltd, Edinburgh, UK) C-MAC® (Karl Storz, Tuttlingen, Germany) GlideScope® Cobalt (Verathon Medical, Bothell, WA, USA). Flexiforce® sensors (A201-25, Tekscan, MA, USA)

Eligibility Criteria

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Inclusion Criteria

* Informed patient consent
* ASA I -III
* Age \> 18 years
* Elective surgery, other than head and/or throat surgery
* Pre-operative Mallampati I -III
* Fasted (≥6 hours)

Exclusion Criteria

* No informed patient consent
* ASA ≥ IV
* Age \< 18 year
* Emergency surgery, surgery of head and/of throat
* Locoregional anaesthesia
* Pre-operative Mallampati IV
* Fasted \< 6 hours
* Pre-operative expected difficult airway
* No teeth, bad dentition
* Dental crowns and/or fixed partial denture

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No