Improvement of Laryngoscopic View by Bed-up-head-elevated Position During Tracheal Intubation in Paediatric Patients

Study Overview
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Brief Summary
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The goal of this prospective observational study is to learn about improvement of laryngoscopic view by Bed-Up-Head-Elevated (BUHE) during tracheal intubation in paediatric patients. The main question it aims to answer is: 1. Does BUHE position improve laryngoscopic view during paediatric intubation? Participants age 3-12 year-old going for elective surgery under general anaesthesia requiring tracheal intubation will undergo laryngoscopic twice, first in sniffing position (SP) and second during BUHE position. POGO score during each laryngoscope will be compared. Additionally, ease of handling of laryngoscope during each position will be assessed.

Detailed Description
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This is a prospective observational study comparing POGO score during tracheal intubation in SP and BUHE position in paediatric patients aged 3 to 12 years who will undergo elective surgery under general anaesthesia requiring tracheal intubation. The first POGO score will be obtained during SP followed by second POGO score during BUHE position and the difference in POGO score before and after BUHE position will be recorded to learn the improvement in POGO score during BUHE position. The objective of this study is to learn the improvement of laryngeal view in tracheal intubation after BUHE position in paediatric patients of age 3 to 12 years. Investigators hypothesised that laryngeal view in tracheal intubation improves after BUHE position compared to sniffing position.

Official Title
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Improvement of Laryngoscopic View by Bed-up-head-elevated Position During Tracheal Intubation in Paediatric Patients

Conditions
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Paediatric Airway Management

Intervention / Treatment
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* Procedure: Intubation in Bed-Up-Head-Elevated (BUHE) position


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 3 to 12 years Elective surgery under general anaesthesia requiring tracheal intubation Exclusion Criteria: Parents' / Guardian's refusal Known case of difficult airway or airway malformation or airway obstruction Patients with respiratory or cardiovascular disease Patients requiring rapid sequence induction Recent Upper Respiratory Tract Infection (URTI) of 2 weeks

Ages Eligible for Study
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Minimum Age: 3 Years
Maximum Age: 12 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Paediatric patients<br> | Procedure: Intubation in Bed-Up-Head-Elevated (BUHE) position<br>* Comparing laryngoscopic view in paediatric patients during sniffing position and BUHE position<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Percentage of Glottic Opening (POGO) score after BUHE position | Compare change in Percentage of Glottic Opening (POGO) score in sniffing position (SP) and after BUHE position. The POGO score is expressed as a percentage of glottis exposure in the laryngoscopy view, which is expressed as 100% for a fully exposed glottis, from the anterior commissure of the vocal cords to the inter-arytenoid notch. POGO score of 0% corresponds to no visualisation of laryngeal structure. | Immediate during procedure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ease of handling of laryngoscope | assessed based on a scale of 0 to 10, 0 being the most difficult and uncomfortable handling and 10 being the easiest and most comfortable handling | Immediate during procedure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Paediatric, Intubation, Laryngoscopy, Head position, BUHE