Endotracheal Tube (ETT) 180: Stylet-loaded Endotracheal Tube Rotation Before Insertion

NCT ID: NCT06231342

Last Updated: 2025-03-25

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

RECRUITING

Clinical Phase

NA

Total Enrollment

357 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-05-31

Study Completion Date

2027-05-31

Brief Summary

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The main objective of the proposed study is to clarify whether rotating a stylet-loaded endotracheal tube (ETT) 180 degrees prior to intubation will decrease the incidence of postoperative throat soreness, when compared to standard technique used in Standard of Care.

Detailed Description

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The researcher who is not blinded will randomize the patient to one of the three groups.

Specific technique and procedure:

* Investigators anesthesiologists assigned to perform the laryngoscopies will be limited to 6 with minimum 2 years of attending experiences to balance the variability. The results of inter-operator bias will be analyzed.
* Endotracheal Tube (ETT) size will be: 7.0 for men and women unless there will be clinical indications to use a different size of Endotracheal Tube.
* Stylet preparation: 75-degree angulation shaped preoperatively and ready for use
* Blade for either McGrath, Macintosh, or direct laryngoscopy will be size 3 for women and size 4 for men.
* Endotracheal Tube (ETT) 180: inserting endotracheal tube loaded with stylet, rotating the tube 180 degree clockwise as soon as the tube tip passes the vocal cords (glottis), and removing the stylet after the tube cuff passes through the vocal cords, which is a common practice.
* Endotracheal Tube cuff filling air pressure will be 20 cmH2O. Inflation will be made using a hand-held airway pressure manometer.
* Patient's data collection will be blinded for both patient and Investigators anesthesiologists assigned to perform the laryngoscopies
* No medications including opiates, monitoring options, and medical decisions will be altered by the study.

A member of the research team will follow-up (in person or phone-call) with each patient in the Post Anesthesia Care Unit (PACU) and 24+/- 3 hours after endotracheal tube removal to collect information regarding any symptoms of hoarseness or sore throat.

Conditions

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Anesthesia, Endotracheal

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A prospective double-blinded randomized trial
Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Outcome Assessors
Subjects and research personnel assessing subjects during follow-ups will be blinded throughout the study. Only the clinicians inside the operative room will be unblinded.

Study Groups

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Direct Laryngoscopy (DL)

Standard laryngoscope use to insert the endotracheal tube and removing the stylet without any rotation.

Group Type ACTIVE_COMPARATOR

Direct Laryngoscope (DL)

Intervention Type DEVICE

DL allows visualization of the larynx. It is used during general anesthesia, for surgical procedures of the larynx, and during resuscitation.

Direct laryngoscopy (DLE) plus Endotracheal Tube (ETT) 180 maneuver

Standard laryngoscope use to insert the endotracheal tube and removing the stylet using a 180-degree rotation.

Group Type ACTIVE_COMPARATOR

Direct Laryngoscope (DL)

Intervention Type DEVICE

DL allows visualization of the larynx. It is used during general anesthesia, for surgical procedures of the larynx, and during resuscitation.

Endotracheal Tube (ETT) 180

Intervention Type PROCEDURE

A novel maneuver has been described to decrease the insult from stylet named Endotracheal Tube (ETT) 180; a clockwise rotation of the stylet-loaded Endotracheal Tube (ETT) 180 degrees on its axis right after the tip of Endotracheal Tube (ETT) passes the patient's vocal cords (glottis) before fully inserting the Endotracheal Tube (ETT) and then, pulling the stylet out. This maneuverer allows the stylet to match the posterior angulation of the trachea.

Video laryngoscopy plus Endotracheal Tube (ETT) 180 maneuver (VLE)

Video laryngoscope use to insert the endotracheal tube and removing the stylet using a 180-degree rotation.

Group Type ACTIVE_COMPARATOR

Video laryngoscope (VL)

Intervention Type DEVICE

VL facilitates intubation while allowing clinicians to share and record real-time high-resolution images and video.

Endotracheal Tube (ETT) 180

Intervention Type PROCEDURE

A novel maneuver has been described to decrease the insult from stylet named Endotracheal Tube (ETT) 180; a clockwise rotation of the stylet-loaded Endotracheal Tube (ETT) 180 degrees on its axis right after the tip of Endotracheal Tube (ETT) passes the patient's vocal cords (glottis) before fully inserting the Endotracheal Tube (ETT) and then, pulling the stylet out. This maneuverer allows the stylet to match the posterior angulation of the trachea.

Interventions

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Direct Laryngoscope (DL)

DL allows visualization of the larynx. It is used during general anesthesia, for surgical procedures of the larynx, and during resuscitation.

Intervention Type DEVICE

Video laryngoscope (VL)

VL facilitates intubation while allowing clinicians to share and record real-time high-resolution images and video.

Intervention Type DEVICE

Endotracheal Tube (ETT) 180

A novel maneuver has been described to decrease the insult from stylet named Endotracheal Tube (ETT) 180; a clockwise rotation of the stylet-loaded Endotracheal Tube (ETT) 180 degrees on its axis right after the tip of Endotracheal Tube (ETT) passes the patient's vocal cords (glottis) before fully inserting the Endotracheal Tube (ETT) and then, pulling the stylet out. This maneuverer allows the stylet to match the posterior angulation of the trachea.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* ASA I - III
* Ambulatory patients undergoing general anesthesia with an Endotracheal Tube (ETT) placement
* Admitted patients undergoing general anesthesia an Endotracheal Tube (ETT) placement
* Age \> 18 and \< 90 years old
* BMI \< 50

Exclusion Criteria

* Age \< 18 years old or age \> 90 years old
* Pregnant women
* Prisoners
* Any surgery involving the pharynx, larynx, vocal cords, trachea that will create confounding factors related to postoperative sore throat
* History of difficult airway
* Critically ill patients requiring intensive care
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ohio State University

OTHER

Sponsor Role lead

Responsible Party

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Suren Soghomonyan

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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The Ohio State University Wexner Medical Center

Columbus, Ohio, United States

Site Status RECRUITING

Countries

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United States

Facility Contacts

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Alberto A Uribe

Role: primary

6142930775

Jeremy Reeves

Role: backup

6142933559

Other Identifiers

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2022H0220

Identifier Type: -

Identifier Source: org_study_id

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