Intubation;Difficult Clinical Trial
Official title:
Comparison of Endotracheal Intubation Over the Aintree Catheter With Fiberoptic Bronchoskop Via the I-gel and Laryngeal Mask Airway Protector
Investigators aimed to compare the ease of use of the LMA protector and I-gel LMA for
tracheal intubation with the Aintree catheter in our study.
Laryngeal mask airway (LMA) protector is the second generation perilaryngeal seal type
supraglottic airway tool. The I-gel LMA is the second generation uncuffed supraglottic airway
device. The Aintree Intubation Catheter has been designed for assisted fiberoptic intubation
and for uncomplicated, atraumatic endotracheal tube exchange.Both LMA types have a structure
that permits endotracheal intubation. In cases of difficult intubation, these two LMA types
can be used. In the literature, there is no study comparing these two LMA types using Aintree
catheter.Difficult Airway Society (DAS) published a guide for tracheal intubation in 2011
using Aintree. According to this guide, LMA type LMA Supreme is the most unfavorable for this
process. However, there is no research or recommendation on the type of LMA most suitable for
use in the literature. In accordance with the data of this study, it will be tried to show
which LMA type may be suitable for intubation with Aintree catheter in patients.
Investigators will include adult patients over 18 years of age who will undergo a surgical
operation requiring intubation. Patients will be divided into protector LMA and I-gel LMA
groups by closed envelope method. Forty patients are planned for both groups. The age,
weight, height, body mass index (BMI) of the patients, operation to be performed, ASA,
mallampati, thyromental distance values will be recorded. A standard induction of anesthesia
will be applied to the patient. After 2 minutes the LMA will be inserted. It will be recorded
how many numbered LMAs are used, success rate, number of trials, optimization maneuver
required. With LMA, whether sufficient amount of tidal volume can be given to the patient and
whether sufficient amount of chest departure is observed during ventilation will be recorded
together with tidal volume values. In patients with adequate ventilation, an Aintree catheter
placed on a fiberoptic bronchoscope in LMA will be delivered. Fiberoptic laryngeal appearance
staging will be performed:
Stage 4: only the cords look Stage 3: cords + posterior epiglot seen Stage 2: cords +
anterior epiglot seen Stage 1: no cords seen Cord vocals will be seen on the monitor and the
aintree catheter will be sent into the trachea. After insertion of the trachea, the
fiberoptic bronchoscope and LMA are removed and the patient's intubation tube is advanced
through the Aintree catheter in the appropriate size and the tube is placed in the trachea.
Once participants have made sure that the tube is trachea, it will be removed. The time from
insertion of the LMA to placement of the endotracheal tube will be coded. During the
procedure, the patient's blood pressure, heart rate, oxygen saturation, any complications
that may develop will be recorded.
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