Optimal Head and Neck Position 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

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-02-11

Study Completion Date

2017-04-27

Brief Summary

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Optimal patient head and neck position when performing videolaryngoscopy for endotracheal intubation has not yet been established.The investigators aim to assess the effect of two different positions on the laryngeal view obtained and success of tracheal intubation during videolaryngoscopy with two commercially available and well established videolaryngoscopes.

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Detailed Description

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The optimum patient head and neck position for direct laryngoscopy (when the anaesthetist views the larynx with a curved metallic blade before passing a tube for ventilation of the lungs) is traditionally considered to be the "sniffing the morning air" (neck flexion and head extension) position. This has been questioned previously as there is no randomized controlled study to date to explore this statement. The patient should be optimally positioned prior to induction of anaesthesia, especially because in the event of an unexpected difficult intubation, the Difficult Airway Society guidelines suggest the use of an alternative laryngoscope. In current clinical practice a videolaryngoscope (a curved blade with a camera attached to it that allows the anaesthetist to see around corners) has been used as an alternative laryngoscope. To the best of our knowledge, the ideal patient position for videolaryngoscopy has not yet been described. The intubation time and rate of success at intubation using a C-Mac D-Blade videolaryngoscope was previously assessed by Serocki et al, but only in the sniffing position. It is possible that adopting a different position when using the C-Mac D- Blade might result in a superior view of the larynx. Furthermore, the optimal patient position has not yet been assessed for intubation with the King Vision videolaryngoscope.

This key information could gain precious seconds in a difficult airway scenario (when securing the airway with a tube for ventilation proves difficult) and has obvious implications for patient management. The answer to this question could also help the anaesthetists take informed decisions when using videolaryngoscopy to intubate the trachea in elective settings. The investigators aim to assess the effect of two different positions on the laryngeal view obtained during videolaryngoscopy with two commercially available and well established videolaryngoscopes to try and answer this question.

Conditions

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Head and Neck Position for Intubation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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C-Mac D-Blade Neutral Position

C-Mac D-Blade videolaryngoscope with patients head and neck in neutral position.

Group Type ACTIVE_COMPARATOR

C-Mac D-Blade Videolaryngoscope

Intervention Type OTHER

Using C-Mac D-Blade Videolaryngoscope patients will be positioned the neutral Head and Neck Position

C-Mac D-Blade Sniffing Position

C-Mac D-Blade videolaryngoscope with patients head and neck in sniffing position.

Group Type ACTIVE_COMPARATOR

C-Mac D-Blade Videolaryngoscope

Intervention Type OTHER

Using C-Mac D-Blade Videolaryngoscope patients will be positioned in Sniffing Head and Neck Position

King Vision Neutral Position

King Vision videolaryngoscope with patients head and neck in neutral position.

Group Type ACTIVE_COMPARATOR

King Vision Videolaryngoscope

Intervention Type OTHER

Using the King Vision Videolaryngoscope patients will be positioned in the neutral Head and Neck Position

King Vision Sniffing Position

King Vision videolaryngoscope with patients head and neck in sniffing position.

Group Type ACTIVE_COMPARATOR

King Vision Videolaryngoscope

Intervention Type OTHER

Using the King Vision Videolaryngoscope patients will be positioned in Sniffing Head and Neck Position

Interventions

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C-Mac D-Blade Videolaryngoscope

Using C-Mac D-Blade Videolaryngoscope patients will be positioned the neutral Head and Neck Position

Intervention Type OTHER

C-Mac D-Blade Videolaryngoscope

Using C-Mac D-Blade Videolaryngoscope patients will be positioned in Sniffing Head and Neck Position

Intervention Type OTHER

King Vision Videolaryngoscope

Using the King Vision Videolaryngoscope patients will be positioned in the neutral Head and Neck Position

Intervention Type OTHER

King Vision Videolaryngoscope

Using the King Vision Videolaryngoscope patients will be positioned in Sniffing Head and Neck Position

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* All patients aged 18 and above, presenting for elective surgical procedure and requiring tracheal intubation will be invited to take part in the study.

Exclusion Criteria

* Patients who are refusing to take part, below 18 years of age, pregnant women, American society of anaesthesiologists' class 4 and above, those requiring rapid sequence indication, super morbidly obese (BMI \>50) and those patients requiring awake fibreoptic intubation will be excluded.

Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No