In a previous study, NCT03147469, the investigators found that the vocal cords were more easily visualized by fiberoptic bronchoscopy with neck extension positioning. On the basis of this finding, the investigators are going to conduct a randomized controlled trial to evaluate the effect of neck extension on the success rate of blind intubation through laryngeal mask. Participants undergoing general anesthesia will be randomly assigned to group E (with neck extension) or group C (with neutral position). Ambu® AuraGain™ laryngeal mask will be placed first, and then, a lubricated endotracheal tube will be gently intubated through the laryngeal mask. The participants will be mechanically ventilated with an endotracheal tube if blind intubation succeed. Blind intubation will be performed with a maximum of two attempts. If all attempts failed, the laryngeal mask will be removed and the tube will be intubated using a direct laryngoscopy. The primary outcome of this study is the success rate of blind intubation within a first attempt. Secondary outcomes included overall success rate of blind intubation within a maximum of two attempts, time for blind intubation, the incidence of postoperative hoarseness, cough, and sore throat, and any obvious complications related to airway management such as bleeding, airway trauma, dental fracture, aspiration, or bronchospasm.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
124
Ambu® AuraGain™ laryngeal mask will be placed first, and then, a lubricated endotracheal tube will be gently intubated through the laryngeal mask under each position according to the assigned group.
Patients' neck will be maximally extended (\~60°) during blind intubation.
Seoul National University Hospital
Seoul, South Korea
Success rate in first attempt
Successful blind intubation in a first attempt
Time frame: In a first attempt for blind intubation, an average of 30 seconds
Overall success rate
Successful blind intubation within a maximum of two attempts
Time frame: In a maximum of two attempts for blind intubation, an average of 60 seconds
Time for blind intubation
Time between insertion of an endotracheal tube within the laryngeal mask and detection of end-tidal CO2 from the tube
Time frame: In a maximum of two attempts for blind intubation, an average of 60 seconds
Postoperative hoarseness
The incidence of postoperative hoarseness
Time frame: 24 hours after extubation
Postoperative cough
The incidence of postoperative cough
Time frame: 24 hours after extubation
Postoperative sore throat
The incidence of postoperative sore throat
Time frame: 24 hours after extubation
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