Neural Integrity Monitor Electromyogram (NIM-EMG) Endotracheal Tube Intubation With Video Laryngoscope
Condition: Intubation; Difficult or Failed; Airway Complication of Anesthesia; Pain, Postoperative; Anesthesia Intubation Complication
MeSH terms: Pain, Postoperative
Study type: Interventional

Summary: 
      Laryngeal nerve monitoring is performed to prevent intraoperative nerve damage in
      thyroidectomy operations. NIM-EMG intubation tube is used while monitoring the recurrent
      laryngeal nerve. Care should be taken when placing this tube. Ensure that the electrodes on
      the tube are in contact with the vocal cords. Both the macintosh laryngoscope and the
      videolaryngoscope can be used when inserting the NIM-EMG tube. The aim of our study is to
      compare these two intubation methods.
    

Detailed description: 
      Anesthesiologists play a key role for the medications used for anesthesia and placement of
      the endotracheal tube in operations with intraoperative monitoring. While placing the NIM-EMG
      tube, the size of the endotracheal tube is very important so that the tube can contact the
      vocal cords.

      The placement of the tube may change due to reasons such as movement of the neck during the
      operation. In addition, endotracheal tube placement may be problematic due to poor vision
      during direct laryngoscopy. Incorrect placement of the tube may result in equipment
      inoperability and increase the likelihood of injury to the recurrent laryngeal nerve.

      Laryngoscopy is a term for tracheal intubation that provides visualization and evaluation of
      the larynx with its upper airway structures.

      Until recently, direct laryngoscopy was considered the standard technique for endotracheal
      intubation. Recently, a wide variety of methods have been developed for endotracheal
      intubation. Video laryngoscopes are similar to direct laryngoscopes but provide laryngeal
      imaging with a small video chip on their blade. This imaging is superior compared to direct
      laryngoscopy. The aim of the study was to compare the use of direct laryngoscopy and video
      laryngoscopy in intubation with the NIM-EMG tube, which is routinely used in operations where
      the recurrent laryngeal nerve (RLN) may be damaged, in terms of intubation success,
      intubation time, tracheal intubation comfort, hemodynamic responses, surgical satisfaction,
      and complications that may develop after anesthesia or surgery.
    

Intervention name(s): Macintosh Laryngoscope; Video Laryngoscope
Intervention type(s): Device; Device
Intervention description(s): After the induction, laryngoscopy will be performed with a Macintosh laryngoscope after 2 minutes of manual ventilation after muscle relaxant by an anesthesiologist with at least 4 years of experience. Patients will be intubated with the "Medtronic Xomed Nerve Integrity Monitor Standard Reinforced ElectromyographyEndotracheal Tube" (size 6.0, 7.0 or 8.0). The cuff of the intubation tube will be connected to a manometer and inflated at a pressure of 20-30 mmHg until there is no air leak. Intubation will be confirmed by the appearance of end-tidal carbon dioxide (CO2). Failed intubation will be considered if not achieved within 2 minutes; After the induction, laryngoscopy will be performed with a Video laryngoscope after 2 minutes of manual ventilation after muscle relaxant by an anesthesiologist with at least 4 years of experience. Patients will be intubated with the "Medtronic Xomed Nerve Integrity Monitor Standard Reinforced ElectromyographyEndotracheal Tube" (size 6.0, 7.0 or 8.0). The cuff of the intubation tube will be connected to a manometer and inflated at a pressure of 20-30 mmHg until there is no air leak. Intubation will be confirmed by the appearance of end-tidal CO2. Failed intubation will be considered if not achieved within 2 minutes
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Screening
Keywords: Videolaryngoscopy; NIM-EMG intubation tube; thyroidectomy; airway management