Effect Of Left Head Rotation On Glottic View During Video Laryngoscopy In Obese Adults

NCT07590739 | Not Yet Recruiting

• 1 other identifier: MoH/CSR/26/31800
• Study Type: observational
• Target: 50
• Locations: 0 countries
• Sites: N/A

Brief Summary

This study aims to evaluate whether the Left Head Rotation (LeHeR) maneuver improves visualization of the vocal cords during video laryngoscopy in obese adult patients undergoing general anesthesia. Obesity is associated with increased difficulty in airway management due to excess upper airway soft tissue and altered anatomy, which may impair visualization during intubation. In this prospective observational study, 50 adult patients with a body mass index (BMI) ≥30 kg/m² will undergo video laryngoscopy using a C-MAC D-blade. The glottic view will be assessed using the Percentage of Glottic Opening (POGO) score in the standard sniffing position and after rotating the head 45 degrees to the left (LeHeR maneuver). A difference in POGO score between the two positions will be analyzed. Secondary outcomes include ease of intubation, number of attempts, time to successful intubation, and occurrence of complications such as desaturation or airway trauma. The study is expected to determine whether the LeHeR maneuver is a simple and effective technique to improve airway visualization in obese patients.

Conditions

Obesity Difficult Airway Airway Management; Difficult Airway

Outcome Measures

Primary Outcomes (1)

• Change in Percentage of Glottic Opening (POGO) Score between Sniffing Position and Left Head Rotation

  The Percentage of Glottic Opening (POGO) score will be assessed during video laryngoscopy in the sniffing position and after 45-degree left head rotation (LeHeR maneuver). The difference in POGO score between the two positions will be recorded for each participant.

  Baseline during induction of anaesthesia at the time of video laryngoscopy on Day 1 (single intra-operative assessment)

Secondary Outcomes (5)

• Time to Successful Intubation

  During induction of anesthesia on Day 1

• Ease of Intubation

  During tracheal intubation on Day 1

• Number of Intubation Attempts

  During tracheal intubation on Day 1

• Requirement of Airway Adjuncts

  During tracheal intubation on Day 1

• Incidence of Peri-intubation Complications

  During induction of anesthesia and tracheal intubation on day 1

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Adult patients aged 18-65 years with body mass index (BMI) ≥30 kg/m², classified as ASA physical status II-III, undergoing elective surgical procedures under general anesthesia requiring orotracheal intubation at a tertiary care hospital.

You may qualify if:

• Adult patients aged 18-65 years
• Body mass index (BMI) ≥30 kg/m²
• ASA physical status I-III
• Scheduled for elective surgical procedures under general anesthesia requiring endotracheal intubation

You may not qualify if:

• Anticipated need for nasal intubation
• Facial or upper airway pathology preventing laryngoscope insertion
• Cervical spine instability or contraindication to head movement
• Pregnant patients

Sponsors & Collaborators

• Royal Hospital, Oman: lead

Central Study Contacts

Kalesh Divakar, MD

CONTACT

+968 92452839; drkalesh@gmail.com

Harihar V Hegde, MD

CONTACT

+968 98845606; drharryhegde@yahoo.co.in

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: April 30, 2026
• First Posted: May 15, 2026
• Study Start: May 1, 2026
• Primary Completion (Estimated): December 1, 2026
• Study Completion (Estimated): January 1, 2027
• Last Updated: May 15, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share