Clinical trial NCT01404780: Comparison of the Glidescope and Macintosh Laryngoscope for Double Lumen Endotracheal Tube Intubation
Official title: Comparison of the Glidescope and Macintosh Laryngoscope for Double Lumen Endotracheal Tube Intubation
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Lung Disease
Keywords: Double lumen ET intubation
Laryngoscope
Lung Surgery
Lead sponsor: University Health Network, Toronto
Sponsor class: OTHER
First posted: 2011-07-28
Enrollment: 70
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

Brief summary: Patients undergoing chest surgery often require insertion of a breathing tube (double lumen tube) after they are unconscious. The double lumen tube enables the anaesthetist to ventilate (assist breathing) one lung at a time. The other lung is partially deflated to enable enough space for the surgeon to perform the procedure. The breathing tube is inserted with a laryngoscope (blade with a light at the end) so the vocal cords can be seen. This is standard medical practise. Two laryngoscopes are commonly used at Toronto General Hospital to insert the tube. The Macintosh laryngoscope has been is use for over 50 years and the Glidescope for over 10 years. Both devices have been extensively researched for single lumen tubes insertion and found to be very safe and effective. Research is limited to say which of the two laryngoscope is the most effective for double lumen tubes.

Detailed description: The Glidescope (GVL) has been extensively studied for single lumen tube intubation and found to be a very safe and useful device. It is a particularly useful for patients with difficult airways as it has a camera attached to the blade. Despite being used for double lumen tube (DLT) intubations, research of its effectiveness and safety, is lacking. The study aims to determine the speed and safety of the GVL for DLT insertion. This information will assist anaesthetists in choosing the appropriate laryngoscope for DLT intubation of their patients.

Eligibility criteria: Inclusion Criteria:

Population: planned elective lung surgery requiring general anaesthesia with a double lumen endotracheal intubation, signed informed patient consent.

Exclusion Criteria:

* Previous failed intubation,
* history of difficult intubation or anticipated difficult intubation (2 risk factors of mallampati score 3 or greater,
* incisor gap \< 3.5cm, thyromental distance \< 6.5cm,
* reduced neck extension and flexion),
* alternative method of intubation indicated eg rapid sequence intubation,
* fibreoptic intubation,
* contra-indication to a left double lumen tube eg endobronchial tumor,
* significant deviation or compression of the trachea and bronchi.,
* contraindication to one lung ventilation eg severe hypoxia or pulmonary hypertension,
* anticipated difficult bag mask ventilation,
* symptomatic gastro-oesophageal reflux,
* oral/pharyngeal/laryngeal carcinoma,
* loose teeth,
* allergy to rocuronium, BMI \> 40.

Primary outcomes:
measure: Time to intubation (laryngoscope or DLT inserted between patient's lips to DLT placement in the trachea and laryngoscope withdrawal)
timeFrame: Number of minutes (0-2) that is required to intubate will be recorded, if a 2nd attempt is required, duration to successfull intubation will be recorded in minutes.
Secondary outcomes:
measure: Time to lung isolation, difficulty of the procedure, complication to the patients
timeFrame: From the beginning of the operative procedure through to 24 hours postoperatively
Other outcomes:
Locations:
city: Toronto
country: Canada
facility: Toronto General Hospital
state: Ontario
Study officials:
affiliation: University Health Network, Toronto General Hospital
name: Adriaan Van Rensburg, MD
role: PRINCIPAL_INVESTIGATOR
References: