TMHT - Difficult Intubation Prediction Using Videolaryngoscopy

Medical University of Silesia

Status: Completed

Conditions: Predictive Value of Tests; Intubation

Treatments: Procedure: Macintosh laryngoscopy; Procedure: McGrath MAC video laryngoscopy

Study type: Interventional

Funder types: Other

Identifiers

NCT03647371

TMHT-03

Details and patient eligibility

About

The purpose of this study is to assess the usefulness of the Thyromental Height Test in prediction of difficult intubation using videolaryngoscopy and double lumen endotracheal tubes in patients scheduled for elective thoracic procedures.

Full description

Successful and fast intubation are crucial for the safety of general anaesthesia. Failed intubation and acute hypoxia remain among the major contributing factors of anaesthesia related deaths. Difficult intubation prevalence in literature is very inconsistent and varies between 1.5-20% of cases in general population, to even 50% in obese Thai population.

There is a number of anthropometric scales and tests used for predicting difficult intubation. However, none of them appears to be sensitive and specific enough to effectively predict difficult intubation.

Recently, simple and non-invasive test predicting difficult intubation was introduced-thyromental height test (TMHT). It shows promise as a more effective substitution for frequently cited anthropometric measures. It is based on the height between the anterior border of the thyroid cartilage and the anterior border of the mentum, measured while the patient lies in the supine position with closed mouth The main objective of the trial is to assess the clinical usefulness of TMHT in prediction of difficult intubation using videolaryngoscopy and double lumen endotracheal tubes in patients scheduled for elective thoracic surgical procedures. The secondary aim is to evaluate usefulness of other commonly used predictive tests associated with difficult intubation.

During routine, preoperative anaesthetic visit thyromental height, thyromental distance, sternomental distance and Mallampati scale score are assessed. Then, during videolaryngoscopy and intubation, score in Cormack-Lehane scale and occurrence of difficult intubation are noted.

Enrollment: 200 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients scheduled for elective thoracic procedures, requiring general anaesthesia, videolaryngoscopy and intubation with a Robert-Shaw type double lumen endotracheal tubes
• written, informed consent for participation in the trail
• older than 18 years

Exclusion criteria

• emergency procedures
• visible anatomic abnormalities
• patients scheduled for awake fibre optic intubation
• lack of consent for participation in the trail

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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200 participants in 2 patient groups

Macintosh laryngoscope

Other group

Description:

direct laryngoscope - laryngoscope with Macintosh blade

Treatment:

Procedure: Macintosh laryngoscopy

McGrath videolaryngoscope

Other group

Description:

McGrath Videolaryngoscope

Treatment:

Procedure: McGrath MAC video laryngoscopy