Comparison of Two Novel Indirect Laryngoscopes to the Macintosh Laryngoscope in Patients With Cervical Spine Immobilization.
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Purpose
It is essential that anaesthetists successfully perform orotracheal intubation in scenarios in which intubation is potentially more difficult, such as where the neck is immobilized.
The Airtraq® Laryngoscope and the CMAC are new intubating devices. They are designed to provide a view of the glottis without alignment of the oral, pharyngeal and tracheal axes.
These devices may be especially effective in situations where intubation of the trachea is potentially difficult.
The efficacy of these devices in comparison to the traditional Macintosh laryngoscope in situations where the cervical spine is immobilized is not known.
The investigators aim to compare the performances of the Airtraq® Laryngoscope and the CMAC to that of the Macintosh laryngoscope, the gold standard device, in patients in which the cervical spine has been immobilized by means of a Manual in-line stabilization of the spine.
Hypothesis: The primary hypothesis is that, in the hands of experienced anaesthetists, time to intubation would be shorter using the indirect laryngoscopes, than using the Macintosh laryngoscope in simulated difficult laryngoscopy.
| Condition | Intervention |
|---|---|
|
Immobilization |
Device: intubate with the macintosh laryngoscope Device: intubate with the C-MAC laryngoscope Device: intubate with the Airtraq device |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
- Rate of successful placement of Tube in the Trachea a. Failed intubation defined as requiring greater than 60s or which resulted in Oesophageal Intubation. b. Successful intubation confirmed by an investigator. [ Time Frame: immediately ] [ Designated as safety issue: Yes ]
- Duration of Intubation attempt (successful Attempts only) a. Absolute time taken to perform successful tracheal intubation b. Number of successful intubations completed within 30 seconds. [ Time Frame: immediatley ] [ Designated as safety issue: Yes ]
- Tracheal Intubation attempts. a. Overall number of attempts at Intubation. b. Number of successful intubations on first attempt [ Time Frame: immediately ] [ Designated as safety issue: Yes ]
- Laryngeal View Obtained a. Cormac and Lehane Grading of Best Laryngeal View b. POGO score [ Time Frame: immediately ] [ Designated as safety issue: Yes ]
- Intubation Difficulty Scale score [ Time Frame: immediately ] [ Designated as safety issue: Yes ]
- Need for and number of optimisation Manoeuvres to aid tracheal intubation [ Time Frame: immediately ] [ Designated as safety issue: Yes ]
| Enrollment: | 90 |
| Study Start Date: | January 2010 |
| Study Completion Date: | November 2010 |
| Primary Completion Date: | November 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Active Comparator: macintosh |
Device: intubate with the macintosh laryngoscope
intubate with the macintosh laryngoscope
|
| Active Comparator: C-MAC |
Device: intubate with the C-MAC laryngoscope
intubate with the C-MAC laryngoscope
|
| Active Comparator: Airtraq |
Device: intubate with the Airtraq device
intubate with the Airtraq device
|
Eligibility| Ages Eligible for Study: | 18 Years to 85 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- ASA 1 - 3
- Aged 18 - 85 years
- Written informed Consent
- No relevant drug allergies
- Mallampatti 1 - 2.
Exclusion Criteria:
- Patients unable to cooperate with airway assessment (2)
Patients with predicted difficult intubation
- Mallampatti III or IV
- Thyromental distance < 6cm
- Mouth opening < 3.5 cm
- Cervical spine disease
- Anteriorly protruding incisors
- Poor Dentition (2)
- Tumours, polyps or foreign bodies in the upper airway (2)
- Patients with documented difficult airways (2).
- Patients with history of or risk factors for gastric regurgitation (i.e. require rapid sequence induction of anaesthesia)
Contacts and Locations
More Information
No publications provided
| Responsible Party: | John G Laffey, National University of Ireland, Galway |
| ClinicalTrials.gov Identifier: | NCT01032460 History of Changes |
| Other Study ID Numbers: | CMAC-3 |
| Study First Received: | December 14, 2009 |
| Last Updated: | November 8, 2010 |
| Health Authority: | Ireland: Institutional Review Board |
Keywords provided by University College Hospital Galway:
|
airway airway device cervical spine immobilisation |
ClinicalTrials.gov processed this record on May 19, 2013