Clinical trial NCT02611141: Retromolar Route Access With and Without A Retromolar Gap
Official title: Retromolar Route Access With and Without A Retromolar Gap - A Visualization Study Of The Vocal Cords
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Airway Management
Keywords: Retromolar Intubation
Lead sponsor: Medical University of Vienna
Sponsor class: OTHER
First posted: 2015-11-20
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Maximum age (years): 99
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: Retromolar Intubation is a successful option for intubation in patients with an existing retromolar gap in the case that the conventional method fails.

Therefore the investigators want to test if the retromolar gap is essential for performing the retromolar intubation technique.

Detailed description: For successful endotracheal intubation an optimal visualisation of the vocal cords is essential. A study comparing retromolar and conventional laryngoscopy showed in patients with an existing retromolar gap, that the retromolar technique is superior for endotracheal intubation especially in patients with a failed 'conventional' intubation attempt. The aim of the following study is to test if a retromolar gap at the right mandible is necessary for the successful performance of the retromolar laryngoscopy technique.

Therefore, 20 patients with and 20 patients without a retromolar gap will be investigated.

The anesthesiologist will visually determine the view of the vocal cords and score it according to Cormack \& Lehane. For an improved view a backward, upward, right-ward pressure (BURP) will be performed, if needed, and scored again.

Finally, endotracheal intubation will be performed by the 'conventional' intubation method. If, however, intubation is not possible, then the retromolar technique will be used. In the case that both methods fail, then any (other) intubation method will (can) be used.

Eligibility criteria: Inclusion Criteria:

* BMI \< 35kg/m2
* Elective surgery
* Absence of at least one molar of the right mandible in arm I (20 patients)

Exclusion Criteria:

* Emergency patients
* Prevalence of reflux disease
* Toothless patients
* Diaphragmatic hernia
* Patient is not sober
* Ventilation problems during induction of anaesthesia
* Patient with a tracheostomy

Primary outcomes:
measure: Cormack & Lehane score (without a backward, upward, rightwards pressure maneuver)
timeFrame: At least 2 minutes after muscle relaxation
measure: Cormack & Lehane score (with a backward, upward, rightwards pressure maneuver)
timeFrame: Approximately 5-10 seconds after the collection of the Outcome Measure 1
Secondary outcomes:
Other outcomes:
Locations:
city: Vienna
country: Austria
facility: Medical University of Vienna
Study officials:
References:
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citation: Martinez-Lage JL, Eslava JM, Cebrecos AI, Marcos O. Retromolar intubation. J Oral Maxillofac Surg. 1998 Mar;56(3):302-5; discussion 305-6. doi: 10.1016/s0278-2391(98)90103-3.