Videolaryngoscope is useful to improve the laryngeal view, especially during difficult intubation. There are several kinds of videolaryngoscopes and it is applicable during nasotracheal intubation. In this study, the investigators will compare the McGrath videolaryngoscope and Pentax-AWS with Macintosh laryngoscope for nasotracheal intubation in patients with manual in-line stabilization.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
120
MILS(Manual in-line stabilization) will be applied during intubation. With MILS, different kinds of laryngoscope will be evaluated in a simulated difficult airway.
McGrath videolaryngoscope will be used for intubation
Pentax AWS videolaryngoscope will be used for intubation
time for intubation
Time frame: from holding the laryngoscope until the 1st ventilation after intubation, within 90 seconds
Cormack Lehane Laryngeal view
Time frame: when laryngoscope is appropriately placed during intubation, approximately 2 seconds
POGP score
Percentage of glottic opening(POGO)
Time frame: when laryngoscope is appropriately placed during intubation, approximately 2 seconds
external laryngeal manipulation
When the laryngeal view is insufficient during laryngoscope, another physician can manipulate the larynx externally to improve the laryngeal view. The necessity of external laryngeal manipulation will be recorded.
Time frame: when laryngoscope is appropriately placed during intubation, approximately 2 seconds
magill forceps
when the nasotracheal tube can not introduced to vocal cord manually, magill forceps can hold the tube to advance the tube through vocal cord. The necessity of magill forceps during intubation will be recorded
Time frame: when laryngoscope is appropriately placed during intubation, approximately 5 seconds
IDS (intubation difficulty scale)
IDS score is the sum of the following seven variables: N1: the number of intubation attempts\>1 N2: the number of operators. 1 N3: the number of alternative intubation techniques used N4: glottic exposure (Cormack Lehane grade minus 1) N5: Lifting force required during laryngoscopy (0=normal; 1=increased) N6: necessity for external laryngeal pressure (0=not applied; 1=applied) N7: position of the vocal cords at intubation (0=abduction/ not visualized; 1=adduction)
Time frame: during intubation, approximately 90 seconds
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Macintosh laryngoscope will be used for intubation
numeric rating scale for intubation
0-10 (0; no difficulty, 10: hardest)
Time frame: during intubation, approximately 90 seconds
grade of bleeding
After confirmation of successful intubation, Yankauer suction was introduced to access the intraoral bleeding during intubation. Grade is 4 points scale (none/trace/moderate/severe).
Time frame: 10 seconds after completion of intubation