Comparative Effectiveness of Intubating Devices in the Morbidly Obese

Cedars-Sinai Medical Center121 enrolled

Overview

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.

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Masking

SINGLE

Enrollment

121

Conditions

Obesity

Interventions

McGrathDEVICE

Intubation with the McGrath device

GlideScopeDEVICE

Intubation with the GlideScope device

Direct Macintosh LaryngoscopyDEVICE

Intubation with Direct Macintosh Laryngoscope

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

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.

Locations (1)

Cedars Sinai Medical Center

Los Angeles, California, United States

Outcomes

Primary Outcomes

Intubation Time Using a Stop Watch

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 frame: up to 3 minutes

Time to Obtain Glottis Visualization (Seconds)

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

Time frame: up to 1 minute

Percentage of Glottic Opening (POGO) [%]

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.

Time frame: up to 1 minute

Glottis View Using the Cormack Lehane Score

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

Time frame: Up to 1 minute

Data from ClinicalTrials.gov

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