The Effect of Paratracheal Pressure on the Glottic View

Study Overview
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Brief Summary
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Paratracheal pressure may have a role in the prevention of pulmonary aspiration. The effects of paratracheal pressure on glottic view, ease of facemask ventilation, or tracheal intubation are not studied yet. In this study, the subjects are divided into two groups (group I: paratracheal pressure applied during induction of anesthesia, group II: conventional Sellick's maneuver applied during induction of anesthesia). Investigators will assess the glottic view during direct laryngoscopy.

Detailed Description
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Primary outcome: -Cormack-Lehane grade Secondary outcome: POGO score before and after application of each intervention Difficulties of mask ventilation after application of each intervention Inspiratory pressure and tidal volume during manual mask ventilation Rates of worsening of the glottic view after intervention The difficulty of endotracheal intubation Intubation time

Official Title
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The Effect of Paratracheal Pressure on the Glottic View During Direct Laryngoscopy : a Randomized Controlled Trial

Conditions
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Paratracheal Pressure, Sellick's Maneuver, Airway Management, Cricoid Pressure

Intervention / Treatment
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* Procedure: Paratracheal pressure
* Procedure: Sellick's maneuver


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult patient undergoing elective surgery with general anesthesia Exclusion Criteria: A patient who does not agree to participate in this study A patient who has a history of cervical/esophageal operation A patient who has a risk of gastric regurgitation A patient who has atherosclerosis of the left carotid artery or history of stroke or angina in 3 months.

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
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Paratracheal pressure<br>Left Paratracheal pressure is applied by ultrasound transducer after confirmation of the location of the esophagus. | Procedure: Paratracheal pressure<br>* Paratracheal pressure is applied by 30N force with the ultrasound transducer.<br>|
| Active Comparator: Sellick's maneuver<br>Conventional Sellick's maneuver is applied. | Procedure: Sellick's maneuver<br>* Conventional Sellick's maneuver is applied by 30N force<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cormack-Lehane grade | Cormack-Lehane grade | During anesthesia induction procedure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| POGO | The percentage of glottic opening (POGO), linear span from the anterior commissure to the interarytenoid notch, 0-100%, higher value represent a better view | During anesthesia induction procedure | 
| Difficulty of mask ventilation | Difficulty of mask ventilation evaluated by the anesthesiologist (Easy/Moderate/Difficult/Impossible) | During anesthesia induction procedure | 
| Inspiration pressure | Pressure to maintain adequated ventilation after application of the intervention | During anesthesia induction procedure | 
| Tidal volume | Tidal volume which is achieved after application of the intervention | During anesthesia induction procedure | 
| Intubation difficulty | Subjective evaluation of the difficulty to pass the endotracheal tube into the glottic opening, easy/moderate/difficult | During anesthesia induction procedure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Paratracheal pressure