Oropharyngeal Space in Videolaryngoscopy

Catharina Ziekenhuis Eindhoven489 enrolled

Overview

In this randomised crossover trial we measure the space between the right side of the laryngoscope blade and the right palatopharyngeal wall in a cohort of ASA I-III patients with a normal mouth opening. We compare the remaining spaces for seven different videolaryngoscopes and compare these to a classic Macintosh laryngoscope.

Intubation using indirect videolaryngoscopy has many advantages over classic direct laryngoscopy using the Macintosh laryngoscope. There are many different videolaryngoscopes available, and the blade differs largely between videolaryngoscopes. Different size and angles of blades may have an impact on the space available for insertion of the endotracheal tube. The space between the blade and the palatopharyngeal wall may be reduced significantly, so that there is less room in the mouth to insert an endotracheal tube. Positioning and manoeuvring of the endotracheal tube may consequently be more difficult and may traumatize the pharynx as was described in a few case reports, especially when an endotracheal tube with a rigid stylet inserted was used.

Study Type

INTERVENTIONAL

Allocation

NON_RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

489

Conditions

Abrasion of Soft Palate Intubation Complication

Interventions

C-MAC ® videolaryngoscopeDEVICE

C-MAC ® videolaryngoscope

Coopdech® videolaryngoscopeDEVICE

Coopdech® videolaryngoscope

McGrath® Series 5 videolaryngoscopeDEVICE

McGrath® Series 5 videolaryngoscope

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Informed patient consent * ASA I - III * Age \> 18 years * Elective surgery, other than head and/or neck surgery * Pre-operative Mallampati I - III * BMI \< 35 kg/m2 * Fasted (≥6 hours) Exclusion Criteria: * No informed patient consent * ASA ≥ IV * Age \< 18 year * Emergency surgery, surgery of head and/of neck * Locoregional anaesthesia * Pre-operative Mallampati IV * BMI \> 35 kg/m2 * Fasted \< 6 hours * Pre-operative expected difficult airway (restrict neck movement, thyromental distance \< 65mm, retrognathia) * Bad, fragile dentition * Dental crowns and/or fixed partial denture

Locations (1)

Catharina Ziekenhuis Eindhoven

Eindhoven, North Brabant, Netherlands

Outcomes

Primary Outcomes

Palatopharyngeal distance

Two laryngoscopes (one classic direct laryngoscope and one indirect videolaryngoscope) will subsequently be inserted into the patient's mouth at random order. With each laryngoscope the horizontal distance between the laryngoscope blade and mid-palatopharyngeal fold will be measured using an mm ruler.