Clinical trial NCT03210922: Semirigid Cervical Collar and Nasotracheal Intubation by Glidescope in Cervical Spine Surgery
Official title: Effect of Semirigid Cervical Collar During Nasotracheal Intubation by Glidescope in the Elective Cervical Spinal Surgical Patients: a Study of Clinical Predictors and Outcomes
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Orthosis
Keywords: cervical collar, nasoendotracheal intubation, glidescope
Lead sponsor: Taipei Veterans General Hospital, Taiwan
Sponsor class: OTHER_GOV
First posted: 2017-07-07
Enrollment: 181
Sex: ALL
Minimum age (years): 20
Maximum age (years): 90
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention 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.
Primary purpose: PREVENTION

Brief summary: 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: 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.

Eligibility criteria: 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.

Primary outcomes:
measure: Nasointubation Time
timeFrame: Intraoperative
Secondary outcomes:
measure: subjective scoring of ease of intubation
timeFrame: Intraoperative
measure: magill forceps for nasointubation
timeFrame: Intraoperative
Other outcomes:
Locations:
city: Taipei
country: Taiwan
facility: Taipei Veterans General Hospital
state: Beitou
Study officials:
affiliation: Center of Neural Regeneration, Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital
name: Wen-Cheng Huang, M.D., Ph.D.
role: PRINCIPAL_INVESTIGATOR
References: