Comparison of Video Laryngoscopy With Rigid Stylet vs Video Laryngoscopy With the TCI Articulating Introducer for Endotracheal Intubation in Simulated Difficult Airways

Study Overview
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Brief Summary
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Purpose: To compare the efficacy and safety of TCI tube core and ordinary tube core assisted tracheal intubation in simulating difficult airway under visual laryngoscope, and to provide reference for clinical application

Detailed Description
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Endotracheal intubation plays an important role in contemporary clinical anesthesia. Direct laryngoscope intubation is the traditional intubation method in anesthesia and emergency medical work. However, due to the constraints of the operator's technical level, the abnormal airway structure and the condition of patients, about 1.5%   8.5% of the cases of intubation difficulties occur. It's even impossible to intubate. Failure of intubation can lead to major complications, including brain damage and death. When a tracheal intubation cannot be placed on the first two attempts, the intubation is classified as difficult, and repeated routine tracheal intubation may lead to morbidity in the patient, and the incidence of airway related complications increases significantly with the number of tracheal intubations. Difficult intubation accounted for 4% of operating room intubation and 10% of intubation outside the operating room. For patients with high glottis and short epiglottis, although the glottis can be seen, intubation is difficult to place. The effectiveness and safety of TCI tube assisted intubation under visual laryngoscope and ordinary tube tube assisted intubation in simulated difficult airway were compared to provide reference for clinical application.

Official Title
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Comparison of Video Laryngoscopy With Rigid Stylet vs Video Laryngoscopy With the TCI Articulating Introducer for Endotracheal Intubation in Simulated Difficult Airways:A Prospective Randomized Controlled Multicenter Study

Conditions
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Intubation; Difficult or Failed

Intervention / Treatment
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* Device: TCI Articulating Introducer
* Device: GlideRite® Rigid Stylet


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Men ≥18 years of age or non-pregnant women; For elective gynecological surgery or upper abdominal surgery under general anesthesia by oral tracheal intubation, the operation position was supine and the operation time was less than 3 hours; Subject's American Society of Anesthesiologists physical status is I-III Subjects who could understand the purpose of the trial, voluntarily participated and signed the informed consent form, and were willing to accept the designated follow-up. Exclusion Criteria: any cerebrovascular accident, such as stroke, transient ischemic attack (TIA), etc. occurred within 3 months; patients with unstable angina pectoris or myocardial infarction within 3 months; laryngeal mass, obstruction, maxillofacial fracture or deformity; Full stomach, high intra-abdominal pressure, habitual vomiting, gastroesophageal reflux disease; pharyngeal infection, hematoma, abscess, tonsil enlargement; Upper respiratory tract infection within one month, fever, cough, runny nose, nasal congestion, etc.; history of chronic airway inflammation, airway hyperresponsiveness or asthma; diabetic patients with severe diabetic complications (diabetic ketoacidosis, hyperosmolar coma, various infections, macroangiopathy, diabetic nephropathy, retinopathy, diabetic cardiomyopathy, diabetic neuropathy, diabetic foot, etc.); severe complications of hypertension, such as arterial dissection, renal failure, cerebral hemorrhage, etc.; reoperation within 3 months; patients with contraindications or allergies to intraoperative drugs; patients enrolled in other studies within 30 days; poor adherence or the investigator's opinion that the patient was not suitable for the study.

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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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Experimental group：TCI Articulating Introducer<br>Tracheal intubation was performed using a TCI core under a visual laryngoscope | Device: TCI Articulating Introducer<br>* use<br>|
| Placebo Comparator: Control group：GlideRite® Rigid Stylet<br>Tracheal intubation was performed under a visual laryngoscope using a common tube core | Device: GlideRite® Rigid Stylet<br>* use<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The success of intubation for the first time | To compare the success rate of first intubation in simulated difficult airway with TCI tube assisted by visual laryngoscope and ordinary tube. | 1 day of surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overall success rate of intubation | Overall success rate of tracheal intubation assisted by TCI and conventional tube cores under video laryngoscope in all included patients | 1 day of surgery | 
| Whether it is necessary to rotate the tracheal tube through the glottis | Whether it is necessary to rotate during tracheal intubation to successfully enter the airway through the glottis | 1 day of surgery | 
| Throat complications | Whether the following conditions will occur after operation: oral mucosal injury: tracheal tube stained with blood or secretion with blood when extubation; Sore throat: patients complained of throat discomfort, manifested as slurred speech, foreign body sensation, cough, etc. Loose teeth; Difficulty speaking; Patients were followed up for 24 hours after surgery to see whether they still had dysphagia, nausea, vomiting, and cough. | 24 hours after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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TCI Articulating Introducer, Endotracheal cannula, Simulated difficult airway