Airway Management Via the Retromolar Route Access

NCT01961817 | Completed

• 1 other identifier: 1386/2013
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

Is there a difference in vocal cord visualization between the retromolar and conventional access?

Conditions

Airway Management; Intubation

Keywords

Retromolar; Difficult Intubation

Outcome Measures

Primary Outcomes (1)

• Comparison of vocal cord visualisation between the retromolar and the conventional method

  In our present clinical trial we intend to compare the vocal cord visualisation by using the retromolar access compared to conventional intubation technique. Visualisation will be performed by randomized sequence and both methods will be performed in each patient. When no 100% visualisation of the vocal cords is achievable, a BURP (backward upward rightward pressure) manoeuvre will be performed. The same procedure will be performed for the another technique as well. For each trial, the anaesthesist has max. 30 seconds time for the vocal cord visualisation and scoring, which includes also the performance of the BURP-manoeuvre. Thereafter, and between each of the vocal cord visualizations as well, the patient will be ventilated by 100% oxygen for at least 20 seconds to reach at least 97% SpO2. Then intubation is performed in all patients by the conventional methode, and if intubation fails the retromolar technique, if possible.

  After Intubation

Study Arms (2)

Retromolar

OTHER

Patients in whom the vocal cord visualisation starts with the retromolar method, which has been randomized determined preoperatively. The second visualization then will be performed with the conventional method.

Other: Retromolar Vocal Cord Visualisation; Other: Conventional Vocal Cord Visualisation

Convenvtional

OTHER

Patients in whom the vocal cord visualisation starts with the conventional method, which has been randomized determined preoperatively. The second visualization then will be performed with the retromolar method.

Other: Retromolar Vocal Cord Visualisation; Other: Conventional Vocal Cord Visualisation

Interventions

Retromolar Vocal Cord Visualisation OTHER

For easier insertion of the laryngoscope the head of the patient will be turned to the left site. Thereafter the blade (Miller) will be inserted into the mouth and pushed carefully as far as possible laterally to receive a direct view of the vocal cords. Then the performing anesthesiologist determine the Cormack \& Lehane score without and thereafter with a BURP (backward upward rightward pressure) maneuver.

Convenvtional; Retromolar

Conventional Vocal Cord Visualisation OTHER

The head of the patient will be positioned as usual. After 2 minutes oxygen insufflation the laryngoscope will be inserted laterally to push the tongue to the left side in order to release the sight to the vocal cords. Thereafter the anesthesiologist determines the Cormack \& Lehane score without and thereafter with performance of the BURP (backward upward rightward pressure) maneuver.

Convenvtional; Retromolar

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age \> 18yr
• BMI \< 30kg/m2
• Elective surgery
• Absence of at least one molar of the right mandible

You may not qualify if:

• Emergency patients
• Prevalence of reflux disease
• Toothless patients
• Diaphragmatic hernia
• Patient is not sober
• Ventilation problems during induction of anaesthesia
• Gastric regurgitation during induction of anaesthesia
• Patient with a tracheostomy

Sponsors & Collaborators

• Medical University of Vienna: lead

Study Sites (1)

Medical University of Vienna

Vienna, Vienna, 1090, Austria

Location

Related Publications (21)

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Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Intervention Model: CROSSOVER
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Ao Univ. Prof. Dr.

Study Record Dates

• First Submitted: October 8, 2013
• First Posted: October 11, 2013
• Study Start: July 1, 2013
• Primary Completion: March 1, 2015
• Study Completion: March 1, 2015
• Last Updated: April 8, 2015

Record last verified: 2015-04

Locations

AU (1)