Positioning during the process of tracheal intubation is critical, as optimal positioning can greatly facilitate successful intubation. Many complications can occur as a result of failed intubation, ranging from airway injury, lack of oxygen, with even deaths. Today, the most popular positioning of patients for intubation is in the "sniffing" position. There is however evidence to support that intubation in the bed-up-head-elevated position may be better. In today's technological age, video assisted laryngoscopy (Laryngoscopy is the process of visualizing the vocal cords prior to intubation), a new method where the anaesthetist intubates a patient via aid of an image guided view of the airway, is increasingly popular due to its reliability and superiority to normal intubation. However, it is not widely available, and may suffer from technical breakdowns. The Glidescope is one example of a video laryngoscope, and has been widely researched in the medical literature. In this study, the investigators wish to investigate whether intubation in the bed-up-head-elevated position will be as good as, if not better than Glidescope assisted tracheal intubation, in patients undergoing elective surgery and planned for general anaesthesia.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
138
Intubation of the trachea with endotracheal tube
With the use of the Glidescope video laryngoscope, the trachea will be intubated with the endotracheal tube
Use of the Macintosh laryngoscope blade size 3
University Malaya Medical Centre
Kuala Lumpur, Kuala Lumpur, Malaysia
Laryngeal exposure
Measured by Percentage of Glottic Opening (POGO) score. A 100% POGO score refers to visualisation of the entire glottic opening from the anterior commissure of the vocal cords to the interarytenoid notch. A POGO score of 0% refers to no visualisation of laryngeal structures. A 100% score is optimal.
Time frame: Through study completion, period of 1 year
Time required for intubation
Measured from the time the tip of the laryngoscope passes through the incisors to the time of the first recorded wave of capnography
Time frame: Through study completion, period of 1 year
Number of intubation attempts
Time frame: Through study completion, period of 1 year
Effort during laryngoscopy
Assessed based on a visual analogue scale, with 10 being the strongest effort, and 1 being the least effort required.
Time frame: Through study completion, period of 1 year
Complications arising from intubation
Incidence of hypoxia, hypotension, or esophageal intubation. Yes/no categories.
Time frame: Through study completion, period of 1 year
Airway trauma
Whether injury occurs to the lips, tongue, teeth, and other structures in the oropharyngeal area. Yes/no categories.
Time frame: Through study completion, period of 1 year
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