Comparison of Video Laryngoscopy and Direct Laryngoscopy for Nasotracheal Intubation During Pediatric Dental Surgery

Study Overview
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Brief Summary
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Background and Objective: Airway control is a condition that should be evaluated primarily in anesthesia practice in the pediatric age group. Failed intubation or prolonged intubation duration can cause atelectasis and hypoxia in children. The aim of this study was to examine the effects of Macintosh laryngoscopy and McGrath videolaryngoscopy on hemodynamic parameters in pediatric patients who were scheduled to undergo elective dental surgery and required intubation for the application of general anesthesia. Methods: Sixty-six patients were divided into two groups according to the procedure used during intubation, namely, direct laryngoscopy or video laryngoscopy. The Cormack-Lehane and Mallampati scores, intubation duration, heart rate at minutes 0, 1, 3 and 5 during intubation, mean arterial pressure, EtCO2and SpO2 values were recorded for all the patients.

Detailed Description
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Many techniques in the management of a difficult airway have been used in adult patients. In pediatric patients, awake fiberoptic intubation is difficult or even impossible . The video laryngoscope is a new tool produced by combining video technology and laryngoscope. Published studies on the video laryngoscope were mostly performed in adults . In this study, we used a Macintosh laryngoscope, which is a routinely used tool in anesthesiology, and a McGrath video laryngoscope, which is a type of a newly developed video laryngoscope that has not widely been used in the pediatric age group. The aim of this study was to examine the effects of Macintosh laryngoscopy and McGrath videolaryngoscopy on hemodynamic parameters in pediatric patients who were scheduled to undergo elective dental surgery and required intubation for the application of general anesthesia. We also evaluated whether Macintosh laryngoscopy and McGrath videolaryngoscopy improved the stress response and whether these approaches facilitated the intubation procedure.

Official Title
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Comparison of Video Laryngoscopy and Direct Laryngoscopy for Nasotracheal Intubation During Pediatric Dental Surgery: a Randomized Clinical Trial

Conditions
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Airway Complication of Anesthesia, Peroperative Complication, Intraoperative Hypertension, Tachycardia, Sinus, Desaturation of Blood

Intervention / Treatment
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* Device: Laryngoscopy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Healthy children between the ages of 4-13 Ordu University School of Medicine ,pediatric age group ,elective oral surgery 4-13 years and who were scheduled for elective oral surgery under general anesthesia with intubation If Patients with a Cormack -Lehane score 1,2 or 3 and if Mallampathy score of 1,2 or 3 were inccluded from the study Exclusion Criteria: With malignancy disease patients with norological disorders with congenital heart disease with airway abnormality with airway disease patients Patients age Under 4 years , Above 13 years If Patients with a Cormack -Lehane score 4 and if Mallampathy score of 4 were excluded from the study -

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 13 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group Direct Laringoscopy<br>Group DL: Group of patients intubated using a Macintoch blade laryngoscope. | Device: Laryngoscopy<br>* During the intubation, the head of the patient was kept in a neutral position, patients were nasotracheally intubated<br>|
| Group Videolaringoscopy<br>Group VL: Group of patients intubated using a McGrath video laryngoscope. | Device: Laryngoscopy<br>* During the intubation, the head of the patient was kept in a neutral position, patients were nasotracheally intubated<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Heart Rate | Heart Rate (HR) | During surgery 0. minute | 
| Heart Rate | Heart Rate (HR) | During surgery 1. minute | 
| Heart Rate | Heart Rate (HR) | During surgery 3. minute | 
| Heart Rate | Heart Rate (HR) | During surgery 5. minute | 
| Heart Rate | Heart Rate (HR) | During surgery 10. minute | 
| Mean Arterial Pressure | Mean Arterial Pressure (MAP) | During surgery 0. minute | 
| Mean Arterial Pressure | Mean Arterial Pressure (MAP) | During surgery 1. minute | 
| Mean Arterial Pressure | Mean Arterial Pressure (MAP) | During surgery 3. minute | 
| Mean Arterial Pressure | Mean Arterial Pressure (MAP) | During surgery 5. minute | 
| Mean Arterial Pressure | Mean Arterial Pressure (MAP) | During surgery 10. minute | 
| Saturation | SpO2 | During surgery 0. minute | 
| Saturation | SpO2 | During surgery 1. minute | 
| Saturation | SpO2 | During surgery 3. minute | 
| Saturation | SpO2 | During surgery 5. minute | 
| Saturation | SpO2 | During surgery 10. minute | 
| End Tidal Carbondioxide | EtCO2 | During surgery 0. minute | 
| End Tidal Carbondioxide | EtCO2 | During surgery 1. minute | 
| End Tidal Carbondioxide | EtCO2 | During surgery 3. minute | 
| End Tidal Carbondioxide | EtCO2 | During surgery 5. minute | 
| End Tidal Carbondioxide | EtCO2 | During surgery 10. minute | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Entubation Time | Entubation time , (minute) | During Surgery 1.minute | 
| Entubation Time | Entubation time , (minute) | During Surgery 2.minute | 
| Entubation Time | Entubation time , (minute) | During Surgery 3.minute | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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pediatric oral surgery, direct laryngoscopy, video laryngoscopy, nasotracheal intubation