NCT02611141

Retromolar Route Access With and Without A Retromolar Gap

Retromolar Route Access With and Without A Retromolar Gap - A Visualization Study Of The Vocal Cords

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 40 (actual)
• Sponsor: Medical University of Vienna · Academic / Other
• Sex: All
• Age: 18 Years – 99 Years
• Healthy volunteers: Not accepted

Summary

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.

Detailed 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.

Conditions

• Airway Management

Interventions

Type	Name	Description
PROCEDURE	Retromolar laryngoscopy and scoring of the visualisation of the vocal cords according to Cormack & Lehane	To facilitate the insertion of the straight blade laryngoscope (Miller #4) the head of the patient will be turned to the left side. The blade will be inserted and then pushed laterally rightwards until the retromolar space will be finally reached. Thereafter the epiglottis will be lifted up in order to achieve the best direct view to the vocal cords and scored according to Cormack \& Lehane . This score will be assessed at least 2 minutes after muscle relaxation: 1. Once without a backward, upward, rightwards pressure maneuver (=BURB) and immediately thereafter (i.e. 5-10 seconds later): 2. If 100% visualization of the vocal cords is not possible a BURP maneuver will be performed and the scored again. Intubation will then be performed by the conventional method using a Macintosh blade #3. In the case that intubation with the conventional method is not successful the retromolar technique will be used.

Timeline

• Start date: 2015-11-01
• Primary completion: 2017-07-01
• Completion: 2017-07-01
• First posted: 2015-11-20
• Last updated: 2018-03-22

Locations

1 site across 1 country: Austria