Intubation Clinical Trial
Official title:
Position of Supraglottic Airway as a Conduit for Tracheal Intubation - A Comparison of CTrach, Intubating LMA and I-gel Supraglottic Airway
Various supraglottic airways may be used as a dedicated airway for insertion of intubating
fibrescope and tracheal intubation in the patients with difficult to manage airways
(Difficult Airway Society Guidelines).
The investigators aim to compare three different types of supraglottic device as a conduit
for tracheal intubation - CTrach optical laryngeal mask, Intubating laryngeal mask airway
and I-gel supraglottic airway. Null hypothesis for this study is that all three devices will
perform without statistical difference in the means of success rate and time needed for
their insertion and tracheal intubation.
Supraglottic airway devices such as I-LMa, Igel and LMA Ctrach are designed to create a
"dedicated" airway which safely allows both spontaneous and controlled ventilation. The use
of supraglottic airways can allow planned fibreoptic intubations in expected difficult cases
and can provide an emergency airway in cases of unexpected difficult airway.
The ILMA (Intavent Orthofix Ltd.,Wokingham, UK) has been designed for either blind or
fibrescope-guided tracheal intubation, in patients with expected and unexpected difficult
airway. Since its development in 1997, it has been used for both blind and fibrescope-guided
tracheal intubations in the patients with difficult airway. The ILMA is currently a 'gold
standard' in supraglottic airways used for tracheal intubation.
The I-gel (Intersurgical Ltd., Wokingham, UK) is a newer dedicated airway device, which with
its wide bore allows direct passage of a tracheal tube.
The CTrach (The Laryngeal Mask Company,Singapore) is a newer device for airway management.
It has special optical fibres built-in inside its bowl and a liquid crystal display which
allows views of the larynx while the endotracheal tube is being placed.
With reference to these supraglottic airway devices, only a small number of case reports
detail tracheal intubation through an I-gel in patients with difficult airways. There have
been manikin studies comparing ILMA and CTrach, and some descriptive studies on the use of
CTrach in patients with predicted difficult airways- but no studies comparing the
performance of these devices in clinical practice.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Outcomes Assessor), Primary Purpose: Treatment
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