The usual intubation technique in the operating room is based on direct laryngoscopy, using a standard Macintosh laryngoscope. However, this skill is not easy to acquire and requires adecuate training. Videolaryngoscopes are becoming a widely accepted airway management technique. because offer better view of the glottis and are easy to use. In addition, indirect laryngoscopes are useful for tracheal intubation by novice operators because of the feedback that supervisors can offer during intubation. The goal of this clinical trial is to learn which intubation technique performed by residents of anesthesia in the operating room is better. The main questions it aims to answer are: * Which intubation technique is more effective for achieving first-attempt intubation? * Which intubation technique results in fewer complications? Researchers will compare both intubation techniques performed by anesthesia residents in the operating room in adult anesthesia cases.
The study will randomize, by means of a computer-generated randomization, approximately 1008 adults in two groups: Conventional group (Laryngoscope with Macintosh Blade) and Videolaryngoscope group (Mac-Style Blade) to be intubated in the operating room by an anesthesia resident. Success rate of the selected technique (first attempt), overall success rate, number of attempts, complications, and duration of insertion for technique will be noted.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
1,008
Anesthesia resident will intubate using a standard laryngoscope.
Anesthesia resident will intubate using a videolaryngoscope (Storz C-MAC, McGrath, Glidescope or other videolaryngoscope)
Complejo Hospitalario Universitario de A Coruña
A Coruña, A Coruña, Spain
RECRUITINGHospital Universitario de Ferrol
Ferrol, A Coruña, Spain
RECRUITINGComplejo Hospitalario Universitario de Santiago
Santiago, A Coruña, Spain
RECRUITINGHospital Universitario Lucus Agusti
Lugo, Lugo, Spain
RECRUITINGHospital Universitario de La Princesa
Madrid, Madrid, Spain
ACTIVE_NOT_RECRUITINGComplexo Hospitalario Universitario de Ourense
Ourense, Ourense, Spain
RECRUITINGComplexo Hospitalario de Pontevedra
Pontevedra, Pontevedra, Spain
RECRUITINGComplejo Hospitalario Alvaro Cunqueiro Vigo
Vigo, Pontevedra, Spain
RECRUITINGHospital POVISA de Vigo
Vigo, Pontevedra, Spain
RECRUITINGDifference in the first attempt success rate (percentage)
Success on the first attempt is defined as successfully passing the tube through the vocal cords in a single laryngoscopy attempt and inserting the endotracheal tube into the trachea
Time frame: During intubation
Comparing the glottic view in the modified Cormack-Lehane scale between the two approaches
Modified Cormack-Lehane grade of glottic view: * I: full view of the glottis * IIa: partial view of the glottis * IIb: arytenoid or the posterior part of the vocal cords just visible * III: only epiglottis visible * IV: neither glottis nor epiglottis visible Cormack-Lehane grade of glottic view
Time frame: During intubation
Difference in percentage of "easy intubation"
To compare the difference in "easy intubation," defined as a Cormack-Lehane grade I-IIa glottic view and successful intubation on the first attempt, between the two intubation approaches.
Time frame: During intubation
Duration of laryngoscopy and tracheal intubation
The interval (in seconds) between the first insertion of a laryngoscope blade into the mouth and the final placement of a tube in the trachea.
Time frame: During intubation
Number of attempts to cannulate the trachea with an endotracheal tube
Number of attempts to cannulate the trachea with an endotracheal tube
Time frame: During intubation
Number of attempts to cannulate the trachea with a bougie.
Number of attempts to cannulate the trachea with a bougie
Time frame: During intubation
Need to change the device for intubation
Need to replace by another videolaryngoscope, a different angled blade, requirement for a fiberoptic bronchoscope...
Time frame: During intubation
Need for additional airway equipment
Airway equipment: bougie, stylet, other videolaryngoscope, others.
Time frame: During intubation
Operator-assessed difficulty of intubation
Operator-assessed difficulty of intubation * without difficulty * mild difficulty * moderate difficulty * severe difficulty
Time frame: During intubation
Use of external laryngeal pressure
External laryngeal pressure: Sellick maneuver or BURP
Time frame: During intubation
Reason for failure to intubate on the first attempt
Reason for failure among those who did not meet the primary outcome (successful intubation on the first attempt): * Inadequate view of the larynx * Inability to intubate the trachea with an endotracheal tube * Inability to cannulate the trachea with a bougie * Attempt aborted due to change in patient condition (e.g., worsening hypoxemia, hypotension, bradycardia, vomiting, bleeding) * Technical failure of the laryngoscope (e.g., battery, light source, camera, screen) * Other
Time frame: During intubation
Complications during intubation
Complications during the procedure and within the following 10 minutes, including: hypotension (SBP \< 80 mmHg), hypotension (SBP \< 65 mmHg), O₂ saturation \< 90%, O₂ saturation \< 80%, bronchoaspiration, esophageal intubation, dental injury, airway injury, and others.
Time frame: Participants will be followed from the beginning of the intervention to 10 minutes after the intervention
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