GlideScope Videolaryngoscopy in Patients With Reduced Mouth Opening

Study Overview
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Brief Summary
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This study aims to evaluate the clinical performance, quality of larynx visualization and difficulty of videolaryngoscopic intubation in patients with a reduced mouth opening (1.0 to 3.0 cm) utilizing the latest generation of GlideScopeTM Spectrum low profile laryngoscopy system.

Detailed Description
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Reduced mouth opening in adults has been proven an important risk factor for difficult endotracheal intubation utilizing both direct and indirect laryngoscopy techniques, and a major reason for anesthesia-related adverse events. Over the past two decades, videolaryngoscopy has evolved to be the primary indirect laryngoscopy technique in a difficult endotracheal intubation setting. The possibility for optimal visualization of the laryngeal structures renders this method particularly helpful in patients with limited mouth opening. Especially videolaryngoscopy with acute-angle blades has been proposed to be favorable over conventional direct laryngoscopy in this setting. However, previous research has shown that a mouth opening of approximately 2.0 - 3.0 cm represents an independent risk factor and a possible critical lower limit for safe videolaryngoscopic intubation. The latest generation of GlideScopeTM Spectrum blades may provide sufficient intubation conditions even in patients with a maximum mouth opening below 3.0 cm. Our research group aims to evaluate the clinical performance, quality of larynx visualization and severity of videolaryngoscopic intubation the GlideScopeTM Spectrum system in patients with a small mouth opening.

Official Title
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GlideScope Videolaryngoscopy in Patients With Reduced Mouth Opening, a Prospective Cohort Study

Conditions
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Intubation;Difficult, Videolaryngoscopy, Small Mouth

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients scheduled for non-cardiac surgery Required general anesthesia and endotracheal intubation Mouth opening between 1.0 and 3.0 cm (any reason) recognized during preoperative assessment Written consent provided Exclusion Criteria: Pregnant or breastfeeding women Confirmed indication for awake fiberoptic intubation, especially due to enoral and pharyngeal tumors, abscesses or other obstructive lesions Endotracheal intubation planned without deep general anesthesia or without neuromuscular blockade (e.g. awake videolaryngoscopy) Qualification for rapid sequence anesthesia induction due to risk of pulmonary aspiration Loose teeth

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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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Successful videolaryngoscopic endotracheal intubation rate | Observation during airway management | Within 1 hour after anesthesia induction | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| First pass success rate | Observation during airway management | Within 1 hour after anesthesia induction | 
| Endotracheal intubation difficulty | Subjective rating on a numeric rating scale [0-100]; 0 - very easy; 100 - very difficult | Within 1 hour after concluded endotracheal intubation | 
| Best view obtained | Cormack-Lehane classification | Within 1 hour after concluded endotracheal intubation | 
| Intubation time | Observation during airway management | Within 1 hour after anesthesia induction | 
| Number of attempts | Observation during airway management | Within 1 hour after anesthesia induction | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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GlideScope, Airway Management, Videolaryngoscopic Intubation