No Post Intubation Laryngeal Symptoms

Study Overview
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Brief Summary
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The purpose of the study is to test a novel endotracheal tube support device that reduces pressure of the tube on the voice box for prevention of post intubation laryngeal symptoms including sore throat, change in voice and trouble swallowing.

Detailed Description
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Single center randomized controlled trial with 100 subjects who will be intubated for already planned surgeries. The participants will be randomized into the control group or the clip group. The clip group will have a small clip (the endotracheal tube support device) placed on the endotracheal tube to reduce the pressure on the vocal cords and larynx. This endotracheal tube support device is made from a FDA approved biocompatible material. The control group subjects will undergo their planned procedure with no intervention during intubation. The clip group will undergo their planned procedure as normal but with the endotracheal tube support device placed on the endotracheal tube by the assigned anesthesia attending physician. The clip is placed once the tube is secured and the ventilator circuit is connected. While extubating the patient, the endotracheal tube will be removed with the clip attached and a picture of the tube will be taken to record the clip location. Before the planned procedure, the investigators will survey the participants to get a baseline for any pre-existing laryngeal symptoms. The same survey will be administered after the procedure when the participants are awake and alert just prior to discharge, 24 hours, 48 hours, and 1 week after the procedure. The survey will ask the participant to indicate yes or no for whether they are experiencing a sore throat, throat pain, oral pain, difficulty speaking, difficulty swallowing, changes in their voice, pain while speaking, and pain while swallowing. If they have indicated yes for any of the symptoms, the participants will also be asked to mark the severity on a visual analog scale from 1 to 10. Other data points will also be collected in this study that are related to the intubation and participant's airway. The investigators will record the total time of the procedure and the length of time the clip is placed on the endotracheal tube. For each participant in the clip group, the investigators will also record the time it takes to place the clip on the endotracheal tube. Each participant's airway will be evaluated, and the investigators will record the thyromental distance, Mallampati score, history of difficult intubation, and the size of the endotracheal tube used. Lastly, data from each participant's intubation will be collected including number of attempts before successful intubation, incidence of dental injury, incidence of lip injury, laryngeal view on Cormack-Lehane scale, and any noted trauma upon extubation. Lastly, the investigators will have the anesthesiologists recruited for the study fill out a modified National Aeronautics and Space Administration (NASA) Task Load Index (TLX) form to evaluate the end-user experience for the device.

Official Title
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Endotracheal Tube Clip for Prevention of Post Intubation Laryngeal Symptoms

Conditions
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Sore-throat, Dysphonia, Dysphagia, Intubation Complication, Throat Disorder, Throat; Wound, Throat Injury, Anesthesia Intubation Complication, Anesthesia Morbidity, Anesthesia Complication, Anesthesia; Adverse Effect, Anesthesia; Reaction

Intervention / Treatment
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* Device: EndoClip


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient undergoing general endotracheal anesthesia with an endotracheal tube Patient is not undergoing a procedure in the head and neck region Exclusion Criteria: Patient with pre-existing severe sore throat, voice change, or trouble swallowing Patient undergoing surgery in the head and neck region

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: 2 arm parallel trial where one group will receive the endotracheal tube clip during general endotracheal anesthesia and the other group will not.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: EndoClip<br>Clip applied to endotracheal tube. | Device: EndoClip<br>* Clip attached to mid portion of the endotracheal tube.<br>* Other names: Endotracheal tube clip;|
| No Intervention: No Clip<br>No clip applied to endotracheal tube. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sore throat on a visual analog scale from 0 (no sore throat) to 10 (worst possible sore throat) | Subjects will indicate whether they are experiencing a sore throat or throat discomfort on a questionnaire. If they indicate 'yes' they will be asked to mark the severity of their symptoms on a visual analog scale ranging from 0 (no sore throat) to 10 (worst possible sore throat). Participants will be asked to report on their symptoms prior to intubation, after intubation on the day of discharge, 24 hours after intubation, 48 hours after intubation, and 1 week after intubation. | Baseline to 1 week after intervention | 
| Change in voice on a visual analog scale from 0 (no voice change) to 10 (most severe voice change) | Subjects will indicate whether they are experiencing a change in voice (i.e. deep and/or hoarse voice, worse than their usual voice quality) on a questionnaire. If they indicate 'yes' they will be asked to mark the severity of their symptoms on a visual analog scale ranging from 0 (no voice change) to 10 (most severe voice change). Participants will be asked to report on their symptoms prior to intubation, after intubation on the day of discharge, 24 hours after intubation, 48 hours after intubation, and 1 week after intubation. | Baseline to 1 week after intervention | 
| Difficulty swallowing on a visual analog scale from 0 (no difficulty swallowing) to 10 (complete inability to swallow) | Subjects will indicate whether they are experiencing difficulty swallowing on a questionnaire. If they indicate 'yes' they will be asked to mark the severity of their symptoms on a visual analog scale ranging from 0 (no difficulty swallowing) to 10 (complete inability to swallow). Participants will be asked to report on their symptoms prior to intubation, after intubation on the day of discharge, 24 hours after intubation, 48 hours after intubation, and 1 week after intubation. | Baseline to 1 week after intervention | 
| Pain in the mouth on a visual analog scale from 0 (no mouth pain) to 10 (worst possible mouth pain) | Subjects will indicate whether they are experiencing mouth pain on a questionnaire. If they indicate 'yes' they will be asked to mark the severity of their symptoms on a visual analog scale ranging from 0 (no mouth pain) to 10 (worst possible mouth pain). Participants will be asked to report on their symptoms prior to intubation, after intubation on the day of discharge, 24 hours after intubation, 48 hours after intubation, and 1 week after intubation. | Baseline to 1 week after intervention | 
| Difficulty talking on a visual analog scale from 0 (no difficulty talking) to 10 (complete inability to talk) | Subjects will indicate whether they are experiencing difficulty talking on a questionnaire. If they indicate 'yes' they will be asked to mark the severity of their symptoms on a visual analog scale ranging from 0 (no difficulty talking) to 10 (complete inability to talk). Participants will be asked to report on their symptoms prior to intubation, after intubation on the day of discharge, 24 hours after intubation, 48 hours after intubation, and 1 week after intubation. | Baseline to 1 week after intervention | 
| Pain in the neck/chest on a visual analog scale from 0 (no neck/chest pain) to 10 (worst possible neck/chest pain) | Subjects will indicate whether they are experiencing pain in the anterior or low region of the neck and/or chest on a questionnaire. If they indicate 'yes' they will be asked to mark the severity of their symptoms on a visual analog scale ranging from 0 (no neck/chest pain) to 10 (worst possible neck/chest pain). Participants will be asked to report on their symptoms prior to intubation, after intubation on the day of discharge, 24 hours after intubation, 48 hours after intubation, and 1 week after intubation. | Baseline to 1 week after intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Endotracheal tube, Anesthesia, Sore throat, Throat pain, Dysphonia, Dysphagia, Throat injury, General anesthesia, Intubation, Endotracheal intubation, Breathing tube, Odynophonia, Odynophagia