Macintosh Laryngoscope Assisted Fiberoptic Intubation

NCT ID: NCT03310866

Last Updated: 2018-10-05

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 100 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2017-12-15
• Study Completion Date: 2018-07-30

Brief Summary

During fiberoptic endotracheal intubation, the perfect airway exposure produced by the classic curved Macintosh laryngoscope in place of head tilt -chin lift-jaw thrust maneuver may increase the accuracy and produce rapid direct vocal cord access in a short time under Inhalation anesthesia to maintain the respiratory drive for grade III&VI Modified Mallampati .

Detailed Description

Managing difficult airway is critical for anesthesia-related morbidity and mortality. Fiberoptic laryngoscope is a reliable tool for endotracheal intubation in difficult airway cases (Modified Mallampatti III&IV), but always there is difficulty to visualize the glottis due to airway tendency to collapse, classically a specific fiberoptic airway with a side way is used and it may added head tilt chin lift jaw thrust. A new technique utilizing sevoflurane anesthesia to maintain the respiratory drive without exposing the patient to the stress of the awake airway instrumentation. Simultaneous utilization of both Macintosh curved laryngoscope and Fiberoptic bronchoscope during Endotracheal intubation (ETT) will be examined for the efficacy during difficult airway management.

All patients should be examined preoperatively for the scoring Modified Mallampati or non tongue protrusion mallampati (NT-MMT) airway score. The pharyngeal structures were then evaluated and the best view (lowest class) was recorded. The classification follows m-MMT and is as follows: class 1, full visibility of tonsils, uvula, and soft palate; class 2, visibility of hard and soft palate, upper portion of tonsils and uvula; class 3, visibility of the soft and hard palate and base of the uvula; and class 4, visibility of only the hard palate, class III or IV patients were included in the study. Inhalational anesthesia use maintains the respiratory drive of the patient allowing less stressful technique.

Conditions

Difficult Intubation

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: NONE

Study Groups

fiberoptic, airway

Classical fiberoptic intubation assisted by side fenestrated airway and head tilt- chin lift- jaw thrust by 2 anesthetist

Group Type: ACTIVE_COMPARATOR

fiberoptic, airway

Intervention Type: DEVICE

classic fiberoptic bronchoscope, fenstrated airway

fiberoptic, Machintosh

oral Fiberoptic bronchoscopic intubation assisted by Macintosh Laryngoscope, by 2 anesthetist

Group Type: EXPERIMENTAL

fiberoptic, Machintosh

Intervention Type: DEVICE

oral fiberoptic brochoscopic, Machintosh laryngoscope

Interventions

fiberoptic, airway

classic fiberoptic bronchoscope, fenstrated airway

Intervention Type: DEVICE

fiberoptic, Machintosh

oral fiberoptic brochoscopic, Machintosh laryngoscope

Intervention Type: DEVICE

Eligibility Criteria

Inclusion Criteria

• Adult patients with Modified Mallampati (NT-MMT) airway score III,VI
• American Society of Anaesthesiologists (ASA) physical class I-III
• Scheduled for elective cancer surgery under general anesthesia

Exclusion Criteria

• Modified Mallampati I,II Airway scored patients.
• History of upper airway surgery.
• Patients with serious deformities of the mandible, maxilla, tongue, pharynx or larynx.
• Patients with a history of significant cardiac and pulmonary diseases,
• Obesity with BMI >40,
• Epilepsy, pregnancy, mental disease, neurological psychological disorders.
• Communication barrier.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Mansoura University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Oncolgy Center, Mansoura University,

Al Mansurah, Dakahlia Governorate, Egypt

Countries

Egypt

Other Identifiers

R/17.08.102

Identifier Type: -

Identifier Source: org_study_id