Retromolar Route Access With and Without A Retromolar Gap

Medical University of Vienna

Status: Completed

Conditions: Airway Management

Treatments: Procedure: Retromolar laryngoscopy and scoring of the visualisation of the vocal cords according to Cormack & Lehane

Study type: Interventional

Funder types: Other

Identifiers

NCT02611141

1848/2015

Details and patient eligibility

About

Retromolar Intubation is a successful option for intubation in patients with an existing retromolar gap in the case that the conventional method fails.

Therefore the investigators want to test if the retromolar gap is essential for performing the retromolar intubation technique.

Full description

For successful endotracheal intubation an optimal visualisation of the vocal cords is essential. A study comparing retromolar and conventional laryngoscopy showed in patients with an existing retromolar gap, that the retromolar technique is superior for endotracheal intubation especially in patients with a failed 'conventional' intubation attempt. The aim of the following study is to test if a retromolar gap at the right mandible is necessary for the successful performance of the retromolar laryngoscopy technique.

Therefore, 20 patients with and 20 patients without a retromolar gap will be investigated.

The anesthesiologist will visually determine the view of the vocal cords and score it according to Cormack & Lehane. For an improved view a backward, upward, right-ward pressure (BURP) will be performed, if needed, and scored again.

Finally, endotracheal intubation will be performed by the 'conventional' intubation method. If, however, intubation is not possible, then the retromolar technique will be used. In the case that both methods fail, then any (other) intubation method will (can) be used.

Enrollment: 40 patients

Sex: All

Ages: 18 to 99 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• BMI < 35kg/m2
• Elective surgery
• Absence of at least one molar of the right mandible in arm I (20 patients)

Exclusion criteria

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

Trial design

Primary purpose: Other

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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40 participants in 2 patient groups

Patient with Retromolar Gap

Other group

Description:

20 patients with a retromolar gap between the last erupted molar and the ascending ramus at the right lower mandible.

Treatment:

Procedure: Retromolar laryngoscopy and scoring of the visualisation of the vocal cords according to Cormack & Lehane

Patient without a Retromolar Gap

Other group

Description:

20 patients without a retromolar gap between the last erupted molar and the ascending ramus at the right lower mandible.

Treatment:

Procedure: Retromolar laryngoscopy and scoring of the visualisation of the vocal cords according to Cormack & Lehane