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Comparative Effectiveness of Intubating Devices in the Morbidly Obese

This study has been completed.
Information provided by (Responsible Party):
Roya Yumul, M.D.,PhD., Cedars-Sinai Medical Center Identifier:
First received: April 23, 2010
Last updated: March 8, 2016
Last verified: March 2016

This prospective, randomized study will compare the effectiveness of 4 different airway intubating devices which are most commonly used.

The four different devices are as follows: McGrath video laryngoscope, GlideScope video laryngoscope, Video-Mac video laryngoscope, and Macintosh size 4 direct laryngoscope.

Condition Intervention Phase
Obesity Device: McGrath Device: GlideScope Device: Direct Macintosh Laryngoscopy Device: Video-Mac Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single Blind (Participant)
Official Title: A Prospective Study Comparing Video Laryngoscopy Devices to Direct Laryngoscopy for Tracheal Intubation of Patients Undergoing Bariatric Surgery

Resource links provided by NLM:

Further study details as provided by Roya Yumul, M.D.,PhD., Cedars-Sinai Medical Center:

Primary Outcome Measures:
  • Intubation Time Using a Stop Watch [ Time Frame: up to 3 minutes ]
    Evaluate if the time it takes to achieve successful tracheal intubation in patients undergoing bariatric surgery (weight loss surgery) will be reduced using the video-mac, glidescope, and McGrath vs direct laryngoscopy.

  • Time to Obtain Glottis Visualization (Seconds) [ Time Frame: up to 1 minute ]

    It is the time (seconds) following initial insertion of laryngoscope blade to obtain a glottic view.

    Start of intubation procedure to Glottic view (the opening between the vocal cords at the upper part of the larynx) visualization comparison between the four devices in patients undergoing bariatric surgery

  • Percentage of Glottic Opening (POGO) [%] [ Time Frame: up to 1 minute ]

    POGO score of 100% denotes visualization of the entire glottic opening in linear fashion from the anterior commissure to the posterior cartilages. If none of the glottic opening is seen, then the POGO score is 0%.

    View of the glottic opening (0-100%) during the intubation process.

  • Glottis View Using the Cormack Lehane Score [ Time Frame: Up to 1 minute ]

    Cormack Lehane score classification:

    Grade 1: Most of the glottis is visible Grade 2: At best almost half of the glottis is seen, at worst only the posterior tip of the arytenoids is seen Grade 3: Only the epiglottis is visible Grade 4: No laryngeal structures are visible

Enrollment: 121
Study Start Date: May 2010
Study Completion Date: October 2011
Primary Completion Date: October 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Video-Mac
Video-Mac device used during intubation procedure
Device: Video-Mac
Intubation with the Video-Mac device
Experimental: GlideScope
GlideScope device used during intubation procedure
Device: GlideScope
Intubation with the GlideScope device
Experimental: McGrath
McGrath device used during intubation procedure
Device: McGrath
Intubation with the McGrath device
Active Comparator: Direct Macintosh Laryngoscopy
Direct Macintosh Laryngoscopy (DL) used during intubation procedure
Device: Direct Macintosh Laryngoscopy
Intubation with Direct Macintosh Laryngoscope

Detailed Description:
Hypothesis: the use of a video laryngoscope will improve the glottic view compared to direct laryngoscopy, and secondarily, use of the video laryngoscope will reduce the time required to achieve successful tracheal intubation in patients undergoing bariatric surgery. (Weight loss surgery). The three types of video laryngoscopy devices include; the Verethon GlideScope, LMA McGrath and Karl-Storz Video-Mac.

Ages Eligible for Study:   18 Years to 80 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patients with a documented body mass index (BMI) of >35.
  • Patients scheduled to undergo inpatient surgery procedures under general anesthesia.
  • Willingness and ability to sign an informed consent document
  • 18 - 80 years of age
  • American Society of Anesthesiologists (ASA) Class II- III adults of either sex.

Exclusion Criteria:

  • Patients who are deemed to be such a significant of an airway risk that they necessitate awake fiberoptic intubation
  • Patients with a history facial abnormalities, oral-pharyngeal cancer or reconstructive surgery
  • Emergency surgeries
  • Pregnancy
  • The inability to tolerate 0.2mg of glycopyrrolate based on tachycardia.
  • Any other conditions or use of any medication which may interfere with the conduct of the study.
  Contacts and Locations
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Please refer to this study by its identifier: NCT01114945

United States, California
Cedars Sinai Medical Center
Los Angeles, California, United States, 90048
Sponsors and Collaborators
Cedars-Sinai Medical Center
Principal Investigator: Roya Yumul, MD, PhD Cedars-Sinai Medical Center
  More Information

Responsible Party: Roya Yumul, M.D.,PhD., Residency program director, Department of anesthesiology, Cedars-Sinai Medical Center Identifier: NCT01114945     History of Changes
Other Study ID Numbers: Pro00019199
Study First Received: April 23, 2010
Results First Received: September 3, 2015
Last Updated: March 8, 2016

Keywords provided by Roya Yumul, M.D.,PhD., Cedars-Sinai Medical Center:
Direct Laryngoscopy
Glottic view
Airway intubating devices
Tracheal intubation processed this record on August 16, 2017