Semirigid Cervical Collar and Nasotracheal Intubation by Glidescope in Cervical Spine Surgery

Study Overview
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Brief Summary
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Effect of semirigid cervical collar during nasotracheal intubation by Glidescope in the elective cervical spinal surgical patients: a study of clinical predictors and outcomes

Detailed Description
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Clinically used cervical orthoses can effectively limit cervical spine motion in all direction and provide protection. Among them, the restriction by Miami semirigid collar was superior, with the least tissue-interface pressure of neck. It is one of the most used semirigid collars for patients' protection in the operating theatre. However, the presence of the semirigid collar was shown to result in a poorer view at laryngoscopy, possibly due to a reduction in mouth opening. Nasotracheal intubation is sometimes applied in cervical spinal surgeries for those receiving anterior approach for a higher cervical spine (C3) level, and/ or combined with a short neck, or due to surgeon's preference. Glidescope minimizes cervical movements during laryngoscopy, facilitates nasotracheal intubation than direct laryngoscopy and requires less technical skill than fiberoptic tracheal intubation. The investigation was to assess the effect of cervical collar on nasotracheal intubation and potential hazard factors of prolonged time for nasotracheal intubation with Gildescope in patients scheduled for elective cervical spinal surgery.

Official Title
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Effect of Semirigid Cervical Collar During Nasotracheal Intubation by Glidescope in the Elective Cervical Spinal Surgical Patients: a Study of Clinical Predictors and Outcomes

Conditions
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Orthosis

Intervention / Treatment
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* Device: Miami cervical collar


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: elective cervical spine surgery scheduled for nasotracheal intubation not requiring orthosis for prophylactic protection Exclusion Criteria: Risk of pulmonary aspiration of gastric contents Pathology of the nasal cavity Abnormal coagulation function Extensive and severe cord compression Refused to sign informed consent.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 90 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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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The patients are randomized into one of the two group: the collar group or the non-collar group before anesthetic induction. In the collar group, the patient was put on a Miami cervical collar and then anesthetic induction and nasotracheal intubation are performed. the non-collar group receive the same anesthetic care without a collar as a control.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Collar group<br>Standard of anesthetic care and nasointubation with patient wearing the Miami cervical collar. | Device: Miami cervical collar<br>* Collar group is put on the Miami cervical collar.<br>|
| No Intervention: Non-collar group<br>Standard of anesthetic care and nasointubation with patient not wearing the Miami cervical collar. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Nasointubation Time | intubation time assisted by Glidescope | Intraoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| subjective scoring of ease of intubation | ease of intubation scored with visual analogue scale | Intraoperative | 
| magill forceps for nasointubation | whether magill forcepts is required to facilitate nasointubation | Intraoperative | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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cervical collar, nasoendotracheal intubation, glidescope