Laryngeal Mask Airway as a Bridge for Intubation of Obese Patients for Sleeve Gastrectomy

Study Overview
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Brief Summary
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Ventilation, as well as intubation of a morbidly obese patient, is challenging and require special preparations and skilful hands, in this study laryngeal mask airway insertion is used as a bridge for intubation to facilitate ventilation as give enough time to anaesthetics and muscle relaxants to work on.

Detailed Description
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The ordinary pathway of intubating a morbidly obese patient for sleeve gastrectomy is bordered by the risk of difficult ventilation and intubation with the subsequent events of hypoxia and hypoventilation. When the patient is easy ventilated, it gives some sort of confidence and pleasure for the anaesthetist that the way of intubation will not be so hard. One problem here is the difficulty of ventilating a morbidly obese patient, in this study the investigators used laryngeal mask airway as a bridge before inserting the endotracheal tube

Official Title
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Assessment of the Use of Laryngeal Mask Airway as Abridge for Intubation of Morbidly Obese Patients Undergoing Sleeve Gastrectomy

Conditions
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Bariatric Surgery Candidate

Intervention / Treatment
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* Device: Laryngeal mask airway
* Device: face mask


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Morbid obese patient BMI>40 ASA I, II, III Elective sleeve gastrectomy Exclusion Criteria: Oral cavity infection or pathological abnormalities Suspected or known abnormalities in supraglottic anatomy Patients planned for awake fiberoptic intubation

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 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
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Face mask ventilation<br>Use of face mask ventilation technique after induction of anaesthesia and administration pf muscle relaxant till the insertion of the endotracheal tube in a morbidly obese patient undergoing sleeve gastrectomy | Device: face mask<br>* use of face mask before intubation of a morbidly obese patient<br>|
| Active Comparator: Laryngeal mask ventilation<br>Use of laryngeal mask airway LMA for ventilation after induction of anaesthesia and administration pf muscle relaxant till the insertion of the endotracheal tube in a morbidly obese patient undergoing sleeve gastrectomy | Device: Laryngeal mask airway<br>* Insertion of laryngeal mask airway before intubation of a morbidly obese patient<br>* Other names: LMA;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to intubation TTI | The time starts with insertion of glidescop and ends at its withdrawal | During the action of intubation after induction of anaesthesia | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| View of the glottis | Based on the percentage of glottic opening (POGO) score as well as Cormack and Lehane's (C&L) classification | During the action of intubation after induction of anaesthesia | 
| Number of attempts required for intubation, | How many times the anaesthetist needs to try to succeed in insertion of the endotracheal tube | During the action of intubation after induction of anaesthesia | 
| Anaesthetist's satisfaction score | On a scale rang from 0 representing totally dissatisfied to 10 representing fully satisfied | During the action of intubation after induction of anaesthesia | 
| Intubation difficulty score (IDS) | Intubation difficulty score (IDS) is the sum of seven variables, each presents 1 point, score 0 represents easy intubation, score 1 to 5 represents moderate difficulty and score more than 5 was considered difficult intubation. | During the action of intubation after induction of anaesthesia | 
| Need for external pressure during intubation | to direct the larynx downward to facilitate endotracheal intubation | During the action of intubation after induction of anaesthesia |