USG vs Palpation for Cricothyroid Membrane Determination

NCT05974540 | Completed

• 1 other identifier: 09.2023.605
• Study Type: observational
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

Emergency cricothyroidotomy is a very important technique to ensure airway safety in acute situations. Problem in identifying the cricothyroid membrane is a major contributor to high failure, as the most common complication during cricothyrotomy is the misplacement of the cannula. The success rate of emergency airway access performed by anesthesiologists and emergency medicine specialists was found to be low due to the low frequency of the procedure. The aim in this study is to compare the palpation method with the ultrasonugraphy (USG)-based method in determining the cricothyroid membrane. The hypothesis is that USG is more successful than palpation in identifying the cricothyroid membrane. In addition, the relationship between difficult intubation and measurements such as the cricothyroid membrane length, the cricoid cartilage and the skin distance, the distance between the cricoid cartilage and the second tracheal ring will be evaluated.

Conditions

Ultrasound; Cricothyroid Membrane

Keywords

Cricothyrotomy; Palpation; Ultrasonography

Outcome Measures

Primary Outcomes (1)

• Distance between palpation-based and USG-based determination of the cricothyroid membrane

  Regarding the determination point of the cricothyroid membrane the distance between palpation-based method performed by pediatric surgeon and USG-based method performed by anesthesiologist will be measured.

  On the 1 day of the surgery. After the anesthesia induction and intubation.

Secondary Outcomes (3)

• Cricothyroid membrane length

  On the 1 day of the surgery. After the anesthesia induction and intubation.

• Skin distance from cricoid cartilage

  On the 1 day of the surgery. After the anesthesia induction and intubation.

• Distance between cricoid cartilage and 2nd tracheal ring

  On the 1 day of the surgery. After the anesthesia induction and intubation.

Interventions

Determination of cricothyroid membrane DIAGNOSTIC_TEST

After the patient's head is extended, the pediatric surgeon will be asked to mark the cricothyroid membrane with a pencil using traditional inspection and palpation methods. Then, the cricothyroid membrane will be determined by the Anesthesiology and Reanimation specialist by USG method and the difference will be determined. Demographic and morphometric characteristics of the patients will be recorded. In addition, the length of the cricothyroid membrane, the distance between the cricoid cartilage and the skin, the distance between the cricoid cartilage and the 2nd tracheal ring will be measured by USG. Mallampati classes of patients with intubation, Cormack-Lehane (CL) glottic appearance grades, Likert scale with intubation difficulties (1: very easy, 2: easy, 3: medium, 4: difficult) will also be recorded.

Eligibility Criteria

• Age: 1 Year - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Non-Probability Sample

Study Population

Pediatric patients between the ages of 1-18, who are in ASA I-II physical status and who will undergo elective surgery under general anesthesia by the Pediatric Surgery at Marmara University Pendik Training and Research Hospital will be included in the study.

You may qualify if:

• American Society of Anaesthesiologists (ASA) I and II physical status
• Elective pediatric surgery
• Patients going to be intubated

You may not qualify if:

• ASA III or above physical status
• Emergency surgery
• Patients having tracheostomy
• Patients going to have laryngeal mask

Sponsors & Collaborators

• Marmara University: lead

Study Sites (1)

Marmara University Department of Anesthesiology and Reanimation

Istanbul, 34912, Turkey (Türkiye)

Location

Study Officials

• Ruslan Abdullayev

  Marmara University Department of Anesthesiology and Reanimation

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assoc. Prof.

Study Record Dates

• First Submitted: July 26, 2023
• First Posted: August 3, 2023
• Study Start: July 1, 2023
• Primary Completion: May 15, 2025
• Study Completion: May 15, 2025
• Last Updated: June 4, 2025

Record last verified: 2024-08

Locations

TU (1)