Thyromental Height Test Versus Sternomental Displacement in Elderly

NCT05414214 | Completed DMC

• 1 other identifier: 45MS-2021
• Study Type: observational
• Target: 150
• Locations: 1 country
• Sites: 1

Brief Summary

The study is designed to evaluate the validity of the SMDD as a predictor of difficult airway in elderly and to compare its validity with that of the TMHT.

Conditions

Difficult Airway

Outcome Measures

Primary Outcomes (1)

• sensitivity, specificity of the sternomental displacement as a predictor of difficult laryngoscopy in elderly surgical patients.

  10 minutes

Secondary Outcomes (5)

• Thyromental Height Test (TMHT)

  10 minutes

• Sternomental displacement (SMDD)

  10 minutes

• Modified Mallampati test (MMT)

  10 minutes

• Cormack-Lehane (CL) grading system

  10 minutes

• The number and duration of intubation attempts

  10 minutes

Study Arms (1)

Elderly

Elderly patients who are scheduled for elective surgeries under general anesthesia with endotracheal intubation accomplished using conventional laryngoscopy will be included.

Procedure: Thyromental Height Test; Procedure: Sternomental displacement; Procedure: General anesthesia

Interventions

Thyromental Height Test PROCEDURE

Thyromental Height Test (TMHT) : will be measured while a patient is lying supine with the head and neck are maintained in a neutral position using a pillow under the head. By using a digital depth gauge, the TMH is the vertical distance measured between the anterior border of the thyroid cartilage directly on the thyroid notch and the anterior border of the mentum.

Elderly

Sternomental displacement PROCEDURE

Sternomental displacement (SMDD): While the patient is sitting with the head in a neutral position, SMD-neutral will be measured using a tape as the distance between upper borders of the manubrium sterni and the mentum. The SMD-extension will then be measured in the same way with the head extended on the neck. The difference between SMD-extension and SMD-neutral will then be calculated as SMDD.

Elderly

General anesthesia PROCEDURE

patients will be pre-oxygenated with 100% oxygen for 3 minutes, anesthesia will be then induced intravenously using fentanyl 2 μg/kg, propofol 1 -1.5 mg/kg, and succinylcholine 1 mg/kg lean body weight. Mask ventilation will be maintained till complete muscle relaxation guided by a peripheral nerve stimulator. Using Macintosh laryngoscopy, an anesthetist who has at least three years experience and who will be blinded to the preoperative tests' results, determined the best laryngeal view by using Cormack-Lehane (CL) grading system from I-IV. External neck manipulation will be used when needed to obtain the best laryngoscopic view. Endotracheal intubation will then be accomplished. The number and duration of intubation attempts will be recorded.

Elderly

Eligibility Criteria

• Age: 65 Years - 90 Years
• Sex: all
• Age Groups: Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

In our study, 150 elderly patients who are scheduled for elective surgeries under general anesthesia with endotracheal intubation accomplished using conventional laryngoscopy will be included.

You may qualify if:

• elderly patients aged ≥ 65 years both male \& female .
• ASA physical status I, II, and III .
• patients scheduled for elective surgeries under general anesthesia .

You may not qualify if:

• Patients undergoing emergency procedure
• patients requiring elective awake fiberoptic.
• patients having neuromuscular disorders or craniofacial abnormalities
• patients with cervical spine surgeries, neck scars, obvious limited neck extension.
• morbid obesity (MBI ˃40 kg/m2)

Sponsors & Collaborators

• Cairo University: lead

Study Sites (1)

Faculty of medicine-Cairo University

Cairo, 1772, Egypt

Location

Related Publications (3)

• Johnson KN, Botros DB, Groban L, Bryan YF. Anatomic and physiopathologic changes affecting the airway of the elderly patient: implications for geriatric-focused airway management. Clin Interv Aging. 2015 Dec 4;10:1925-34. doi: 10.2147/CIA.S93796. eCollection 2015.

  PMID: 26673904 BACKGROUND

• Etezadi F, Ahangari A, Shokri H, Najafi A, Khajavi MR, Daghigh M, Moharari RS. Thyromental height: a new clinical test for prediction of difficult laryngoscopy. Anesth Analg. 2013 Dec;117(6):1347-51. doi: 10.1213/ANE.0b013e3182a8c734.

  PMID: 24257384 BACKGROUND

• Prakash S, Mullick P, Bhandari S, Kumar A, Gogia AR, Singh R. Sternomental distance and sternomental displacement as predictors of difficult laryngoscopy and intubation in adult patients. Saudi J Anaesth. 2017 Jul-Sep;11(3):273-278. doi: 10.4103/1658-354X.206798.

  PMID: 28757825 BACKGROUND

MeSH Terms

Interventions

Anesthesia, General

Intervention Hierarchy (Ancestors)

Anesthesia; Anesthesia and Analgesia

Study Officials

• Abeer Ahmed, MD

  Cairo University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: assisstant professor

Study Record Dates

• First Submitted: June 8, 2022
• First Posted: June 10, 2022
• Study Start: June 10, 2022
• Primary Completion: August 20, 2022
• Study Completion: September 10, 2022
• Last Updated: September 15, 2022

Record last verified: 2022-09

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)