Airway Management Via the Retromolar Route Access

NCT ID: NCT01961817

Last Updated: 2015-04-08

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

2013-07-31

Study Completion Date

2015-03-31

Brief Summary

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Is there a difference in vocal cord visualization between the retromolar and conventional access?

Detailed Description

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Management of the difficult airway is still an essential part of modern anaesthesia. Up to now, there have bee no clinical investigations comparing the intubation method via the retromolar route (RM), with the conventional intubation route (CM).

For the present clinical investigation, 100 patients undergoing elective surgery will be investigated in the General Hospital of Vienna when for the anaesthesia intubation is required. In both intubation methods (RM and CM) the anaesthesiologist will visually determine the Cormack \& Lehane score in a randomly assigned sequence with and without a BURP-manoeuvre (= backwards, upwards and rightwards pressure). Thereafter intubation is performed in all patients by the CM method and if intubation fails the RM technique will be used. Of course, as per usual, every intubation trial is interrupted by a 20 second 100%-oxygen-ventilation period to reach a pulse oximetry oxygen saturation of at least 97% SpO2. Thereafter, if intubation fails again every other intubation technique will be applied, as necessary and called for.

Conditions

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Airway Management Intubation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Blinding Strategy

NONE

Study Groups

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Retromolar

Patients in whom the vocal cord visualisation starts with the retromolar method, which has been randomized determined preoperatively.

The second visualization then will be performed with the conventional method.

Group Type OTHER

Retromolar Vocal Cord Visualisation

Intervention Type OTHER

For easier insertion of the laryngoscope the head of the patient will be turned to the left site. Thereafter the blade (Miller) will be inserted into the mouth and pushed carefully as far as possible laterally to receive a direct view of the vocal cords. Then the performing anesthesiologist determine the Cormack \& Lehane score without and thereafter with a BURP (backward upward rightward pressure) maneuver.

Conventional Vocal Cord Visualisation

Intervention Type OTHER

The head of the patient will be positioned as usual. After 2 minutes oxygen insufflation the laryngoscope will be inserted laterally to push the tongue to the left side in order to release the sight to the vocal cords. Thereafter the anesthesiologist determines the Cormack \& Lehane score without and thereafter with performance of the BURP (backward upward rightward pressure) maneuver.

Convenvtional

Patients in whom the vocal cord visualisation starts with the conventional method, which has been randomized determined preoperatively.

The second visualization then will be performed with the retromolar method.

Group Type OTHER

Retromolar Vocal Cord Visualisation

Intervention Type OTHER

For easier insertion of the laryngoscope the head of the patient will be turned to the left site. Thereafter the blade (Miller) will be inserted into the mouth and pushed carefully as far as possible laterally to receive a direct view of the vocal cords. Then the performing anesthesiologist determine the Cormack \& Lehane score without and thereafter with a BURP (backward upward rightward pressure) maneuver.

Conventional Vocal Cord Visualisation

Intervention Type OTHER

The head of the patient will be positioned as usual. After 2 minutes oxygen insufflation the laryngoscope will be inserted laterally to push the tongue to the left side in order to release the sight to the vocal cords. Thereafter the anesthesiologist determines the Cormack \& Lehane score without and thereafter with performance of the BURP (backward upward rightward pressure) maneuver.

Interventions

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Retromolar Vocal Cord Visualisation

For easier insertion of the laryngoscope the head of the patient will be turned to the left site. Thereafter the blade (Miller) will be inserted into the mouth and pushed carefully as far as possible laterally to receive a direct view of the vocal cords. Then the performing anesthesiologist determine the Cormack \& Lehane score without and thereafter with a BURP (backward upward rightward pressure) maneuver.

Intervention Type OTHER

Conventional Vocal Cord Visualisation

The head of the patient will be positioned as usual. After 2 minutes oxygen insufflation the laryngoscope will be inserted laterally to push the tongue to the left side in order to release the sight to the vocal cords. Thereafter the anesthesiologist determines the Cormack \& Lehane score without and thereafter with performance of the BURP (backward upward rightward pressure) maneuver.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age \> 18yr
* BMI \< 30kg/m2
* Elective surgery
* Absence of at least one molar of the right mandible

Exclusion Criteria

* Emergency patients
* Prevalence of reflux disease
* Toothless patients
* Diaphragmatic hernia
* Patient is not sober
* Ventilation problems during induction of anaesthesia
* Gastric regurgitation during induction of anaesthesia
* Patient with a tracheostomy
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical University of Vienna

OTHER

Sponsor Role lead

Responsible Party

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Wolfgang SCHRAMM

Ao Univ. Prof. Dr.

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Medical University of Vienna

Vienna, Vienna, Austria

Site Status

Countries

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Austria

References

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Reference Type BACKGROUND
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Cooper RM. Complications associated with the use of the GlideScope videolaryngoscope. Can J Anaesth. 2007 Jan;54(1):54-7. doi: 10.1007/BF03021900.

Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
PMID: 20674088 (View on PubMed)

Mallampati SR, Gatt SP, Gugino LD, Desai SP, Waraksa B, Freiberger D, Liu PL. A clinical sign to predict difficult tracheal intubation: a prospective study. Can Anaesth Soc J. 1985 Jul;32(4):429-34. doi: 10.1007/BF03011357.

Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
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Reference Type BACKGROUND
PMID: 22050948 (View on PubMed)

Other Identifiers

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1386/2013

Identifier Type: -

Identifier Source: org_study_id

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