Comparison of Video Laryngoscope Using Miller or Macintosh Approach During Endotracheal Intubation

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

247 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-10-04

Study Completion Date

2021-11-22

Brief Summary

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Video laryngoscope has become recommended option during difficult intubation. Guidelines of ASA at 2013 had suggested using video laryngoscope after failure intubation of direct laryngoscope. Varieties of video laryngoscope had been invented with different curves. We call the one which has the same curve of Macintosh laryngoscope as conventional video laryngoscope in this study. Mostly, the way of using conventional video laryngoscope is suggested as Macintosh method. However, with the front positioning camera, Miller method can theoretically improve the glottic opening. We intend to discuss whether using Miller approach with conventional video laryngoscope can improve glottic opening or not.

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Detailed Description

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Video scope can provide better glottic opening by increase the tilting angle of the tip, and the position of camera can provide larger vision angle. However, while the angle increases, the endotracheal tube must fallow the curve, which may require learning curve of the operator. In Glidescope as example, increase the tilting angle can help with glottic exposure, however the steep curve will simultaneously increase the difficulty of inserting the tube or using Magill forceps, especially while intubating double lumen or nasal endotracheal tube. Conventional video laryngoscope in this study indicates the video laryngoscope blade which has the same curve as Macintosh laryngoscope. It mainly improves the glottic view by front positioning camera.

Anesthesiologist usually place the tip of the blade at vallecula to expose the glottic which is the conventional ways of using Macintosh blade which we name it as Macintosh method. Placing the tip below the epiglottis and lift it up directly is the way of using Miller blade. Theoretically, the Miller method with conventional video laryngoscope may improve the scale of glottic exposure measured with Cormack-Lehane grade. This is a one-group pretest-posttest study to compare the Cormack-Lehane grade with two different methods in the same patient. This study tends to discuss whether this combination can improve the glottic exposure and preserve the advantage of direct laryngoscope.

Conditions

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Difficult Intubation

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

one-group pretest-posttest study

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Intubation with Miller approach

Posttest group: Patient receive intubation with conventional video laryngoscope with Miller approach.

Pretest group: Patient receive intubation with conventional video laryngoscope with Macintosh approach.

Group Type EXPERIMENTAL

Video laryngoscope with Miller approach

Intervention Type PROCEDURE

Miller approach indicates lifting epiglottis during laryngoscopy, which is the way of using Miller laryngoscope

Interventions

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Video laryngoscope with Miller approach

Miller approach indicates lifting epiglottis during laryngoscopy, which is the way of using Miller laryngoscope

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Aged\>20
2. Scheduled to received operation that required general anesthesia with endotracheal tube \[3\] ASA I, II

Exclusion Criteria

1. Emergent surgery
2. pregnant
3. Limited mouth opening
4. Poor dental condition
5. Airway obstruction (oral tumor, hypopharyngeal cancer….etc)
6. Deep neck infection
7. Allergic to any anesthetic

Minimum Eligible Age

20 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No