Optimal Head and Neck Position During Videolaryngoscopy
Condition: Head and Neck Position for Intubation
Study type: Interventional

Summary: 
      Optimal patient head and neck position when performing videolaryngoscopy for endotracheal
      intubation has not yet been established.The investigators aim to assess the effect of two
      different positions on the laryngeal view obtained and success of tracheal intubation during
      videolaryngoscopy with two commercially available and well established videolaryngoscopes.
    

Detailed description: 
      The optimum patient head and neck position for direct laryngoscopy (when the anaesthetist
      views the larynx with a curved metallic blade before passing a tube for ventilation of the
      lungs) is traditionally considered to be the "sniffing the morning air" (neck flexion and
      head extension) position. This has been questioned previously as there is no randomized
      controlled study to date to explore this statement. The patient should be optimally
      positioned prior to induction of anaesthesia, especially because in the event of an
      unexpected difficult intubation, the Difficult Airway Society guidelines suggest the use of
      an alternative laryngoscope. In current clinical practice a videolaryngoscope (a curved blade
      with a camera attached to it that allows the anaesthetist to see around corners) has been
      used as an alternative laryngoscope. To the best of our knowledge, the ideal patient position
      for videolaryngoscopy has not yet been described. The intubation time and rate of success at
      intubation using a C-Mac D-Blade videolaryngoscope was previously assessed by Serocki et al,
      but only in the sniffing position. It is possible that adopting a different position when
      using the C-Mac D- Blade might result in a superior view of the larynx. Furthermore, the
      optimal patient position has not yet been assessed for intubation with the King Vision
      videolaryngoscope.

      This key information could gain precious seconds in a difficult airway scenario (when
      securing the airway with a tube for ventilation proves difficult) and has obvious
      implications for patient management. The answer to this question could also help the
      anaesthetists take informed decisions when using videolaryngoscopy to intubate the trachea in
      elective settings. The investigators aim to assess the effect of two different positions on
      the laryngeal view obtained during videolaryngoscopy with two commercially available and well
      established videolaryngoscopes to try and answer this question.
    

Intervention name(s): C-Mac D-Blade Videolaryngoscope; C-Mac D-Blade Videolaryngoscope; King Vision Videolaryngoscope; King Vision Videolaryngoscope
Intervention type(s): Other; Other; Other; Other
Intervention description(s): Using C-Mac D-Blade Videolaryngoscope patients will be positioned the neutral Head and Neck Position; Using C-Mac D-Blade Videolaryngoscope patients will be positioned in Sniffing Head and Neck Position; Using the King Vision Videolaryngoscope patients will be positioned in the neutral Head and Neck Position; Using the King Vision Videolaryngoscope patients will be positioned in Sniffing Head and Neck Position
Intervention MeSH terms: Pyrithione zinc
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Head Neck Position Videolaryngoscopy