Comparison of Haemodynamic Effects During Orotracheal Intubation, by Direct or Indirect Laryngoscopy With Airtraq

University Hospital, Lille218 enrolled

Overview

News techniques of intubation by indirect laryngoscopy have arrived in operating rooms but they are still too restricted to situations (difficult intubation criteria ..). It wanted to focus on indirect laryngoscopy by Airtraq. This technique allows better exposure during intubation while limiting mouth opening and cervical hyper extension, but also dental trauma and lip wounds. It also reduces the duration of laryngoscopy and therefore at the same time the apnea time. After a review of the literature, it has been proven that its use reduces haemodynamic changes during intubation. But these studies have been realized only in very particular patients (obese, heart failure) and with induction protocols that are not used routinely in our operating theaters. Reasons why it decided to carry out this study, on the one hand to find these results and especially to be able to extend them to the whole population.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

DIAGNOSTIC

Masking

SINGLE

Enrollment

218

Conditions

Orotracheal Intubation

Interventions

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Specific medical conditions: ASA 1 or 2 * Patient having given written consent to participate in the category 2 trial * Intubation realized by experienced person * Social Insured Patient * Patient willing to comply with all procedures of the study and its duration Exclusion Criteria: * Demographic characteristics: minor, over 65 * Medical history: history of difficult intubation, hypertension * Lille intubation score greater than or equal to 7 * Treatments in progress: Beta taking blocking the day of the operation. * Administrative reasons: inability to receive informed information, inability to participate in the entire study, lack of coverage by the social security system, refusal to sign consent

Outcomes

Primary Outcomes

change from intubation mean blood pressure at 1 min after intubation

Time frame: between the values before intubation (T0) and 1min after intubation.

Secondary Outcomes

Frequency of patients with hemodynamic reaction post intubation (minimal variation of mean blood pressure or heart rate of 20%

Time frame: between values before intubation and 1, 2, 5, 10 minutes after intubation.

Variation of blood pressure (PAM)

Time frame: between the values before intubation (T0) and 2, 5 and 10 minutes of intubation

Variation of heart rate (HR)

Time frame: between the values before intubation (T0) and 1, 2, 5 and 10 minutes of intubation

Mean of the arterial blood pressure and heart rate

delta defined by the difference between the values

Time frame: before intubation and at 1,2,5 and 10 minutes from intubation.

Intubation time in seconds from introduction of the intubation device into the mouth with inflation of the balloon

Time frame: at 1 min after intubation

Frequency of patients with dental trauma and / or an injury to the lips due to the intubation device.

Time frame: at 10 min after intubation

instantaneous ANI delta

Time frame: between ANI before intubation and 1,2,5 and 10 min after intubation