Three Different Techniques for Tracheal Intubation Via Supraglottic Airway Devices

NCT ID: NCT04346459

Last Updated: 2023-07-03

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

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-10

Study Completion Date

2023-03-23

Brief Summary

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This study compares three different supraglottic airway devices used as a conduit for tracheal intubation in order το determine which one achieves the highest success rate of first attempt intubation

Detailed Description

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Prospective, randomized, comparative, clinical, controlled study, that is approved by the Ethics Commitee of the University of Patras (10.12.2019) and takes part in the University Hospital of Patras. Depending on the supraglottic airway device (SGA)/ laryngeal mask airway (LMA) used to achieve intubation (Fastrach, I-gel, Protector), partcipants will be randomly allocated into three groups; Group A, B and C (Fastrach, I-gel, Protector respectively).

In the preoperative setting, a complete preanesthetic evaluation will be performed, including a detailed airway assessment (prediction of difficulty in face mask ventilation, insertion of SGA/LMA and intubation).

All patients are scheduled to undergo an elective surgery under general anesthesia. Before induction, all patients will be preoxygenated with FiO2 100% for at least 5 minutes. After induction, using rocuronium 0.6mg/kg to facilitate neuromuscular blockade, face mask ventilation follows.

1. Group A- Fastrach: The intubating laryngeal mask airway (Fastrach) will be placed to the patients of this group. After the mask is correctly placed and patients are adequately ventilated, they will be intubated through the mask using its own endotracheal tube according to the blind technique insertion.
2. Group B- I-gel: The supraglottic airway device (I-gel) will be placed to the patients of this group. After the mask is correctly placed and patients are adequately ventilated, they will be intubated through the mask using a fiberoptic bronchoscope to guide endotracheal tube's placement.
3. Group C- Protector: The supraglottic airway device (Protector) will be placed to the patients of this group. After the mask is correctly placed and patients are adequately ventilated, they will be intubated through the mask using a fiberoptic bronchoscope to guide endotracheal tube's placement.

In all groups (A, B, C) up to 3 attempts of SGA/LMA placement and up to 3 attempts of intubation are allowed to be made.

In case of an emerging unpredicted difficult airway and a concurrent unsuccessful SGA/LMA placement, then the algorithm of the difficult airway will be immediately followed. Video-assisted laryngoscopy will be the first option rescue alternative.

The time of the whole procedure from the beginning of SGA's/LMA's placement effort until the successful intubation will be recorded, along with the evaluation of the success rate of first intubation attempt.

Conditions

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Tracheal Intubation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Group A- Fastrach (control group)

Group of 40 patients scheduled for elective surgery under general anesthesia are planned to be intubated using intubating laryngeal mask airway "Fastrach" following blind intubating method through "Fastrach"

Group Type ACTIVE_COMPARATOR

Tracheal intubation through "Fastrach" - Group A

Intervention Type PROCEDURE

Insertion of the intubating laryngeal mask "Fastrach" and blind tracheal intubation through the device

Group B- I-gel

Group of 40 patients scheduled for elective surgery under general anesthesia are planned to be intubated using "I-gel" supraglottic airway device as a conduit for tracheal intubation guided by a fiberoptic bronchoscope.

Group Type ACTIVE_COMPARATOR

Tracheal intubation through "I-gel" - Group B

Intervention Type PROCEDURE

Insertion of the supraglottic airway device "i-gel" and tracheal intubation through the device guided by a fiberoptic bronchoscope

Group C- Protector

Group of 40 patients scheduled for elective surgery under general anesthesia are planned to be intubated using the "Protector" laryngeal mask airway as a conduit for tracheal intubation guided by a fiberoptic bronchoscope.

Group Type ACTIVE_COMPARATOR

Tracheal intubation through "Protector" - Group C

Intervention Type PROCEDURE

Insertion of the laryngeal mask "Protector" and tracheal intubation through the device guided by a fiberoptic bronchoscope

Interventions

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Tracheal intubation through "Fastrach" - Group A

Insertion of the intubating laryngeal mask "Fastrach" and blind tracheal intubation through the device

Intervention Type PROCEDURE

Tracheal intubation through "I-gel" - Group B

Insertion of the supraglottic airway device "i-gel" and tracheal intubation through the device guided by a fiberoptic bronchoscope

Intervention Type PROCEDURE

Tracheal intubation through "Protector" - Group C

Insertion of the laryngeal mask "Protector" and tracheal intubation through the device guided by a fiberoptic bronchoscope

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients (age ≥ 18 yrs) scheduled for an elective surgery under general anesthesia
* Written informed consent to participate in the trial

Exclusion Criteria

* Age \< 18 yrs
* Non- elective (urgent/ emergency) procedures or multi-trauma patients
* Obstetric population
* Surgery performed under regional anesthesia
* Contraindication to LMA insertion
* Predicted difficulty in LMA insertion (at least one out of four "RODS" criteria)
* Contraindication to the use of neuromuscular blockade or situations that require spontaneous breathing
* Indication for awake intubation or surgical airway
* Patients' involvement in another clinical trial
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital of Patras

OTHER

Sponsor Role lead

Responsible Party

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Maria Spyraki

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Gregorios Voyagis, MD, PhD

Role: STUDY_CHAIR

University of Patras, Department of Anesthesiology and Critical Care

Locations

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University Hospital of Patras

Pátrai, Achaia, Greece

Site Status

Countries

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Greece

Other Identifiers

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11/11/2019anesthesia

Identifier Type: -

Identifier Source: org_study_id

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