Clinical Trials Logo

Clinical Trial Summary

In recent decades, numerous videolaryngoscopes have been introduced to facilitate tracheal intubation. However, it remains unclear whether videolaryngoscope will increase the successful tracheal intubation compared with usual Macintosch laryngoscope. Therefore, this pilot study is a randomized controlled trial designed to compare the first-pass intubation success of the Airtraq laryngoscope versus the Macintosh direct laryngoscope in patients requiring general anesthesia for elective operation, with the aims to examine the feasibility of a large multicentre effectiveness trial by assessing recruitment targets, testing the data completeness, and local incidence of first-pass intubation success.


Clinical Trial Description

In recent decades, numerous videolaryngoscopes have been introduced to facilitate tracheal intubation. However, it remains unclear whether videolaryngoscope will increase the successful tracheal intubation compared with usual Macintosch laryngoscope. In a quantitative review on the performance of several non-standard laryngoscopes (e.g. Bonfils, CTrach, Glidescope), no strong evidence has been identified to support these devices to supersede the Macintosh laryngoscope. Owing to the lacks of randomized trials at the time, Airtraq has not been reviewed in the analysis.

The Airtraq laryngoscope is one of the optical indirect laryngoscopes, which provides glottis display without any deviation in the normal position of the oral, pharyngeal or the tracheal axes. Unlike other videolaryngoscopes, the Airtraq larygoscope is a non-steering novel airway device which has a guide channel for tracheal tube alongside with the blade. Its use has been showed to improve the ease of intubation in difficult airway situations. Up to date, randomized controlled trials comparing the Airtraq and Macintosh direct laryngoscopes are either small scaled or focusing on specific populations. And instead of the first-attempt success rate, the primary endpoints adopted have focused on the glottic view, intubation time, and cervical spine movement. The Difficult Airway Society has highlighted the importance of a robust and high standard of evidence to assess the use of new devices in airway management. Knowing that failed tracheal intubation has remained a major contribution to anesthetic-related morbidity and mortality, clinical relevant endpoint is essential to guide the selection of airway devices for tracheal intubation. Considering reports on unsuccessful tracheal intubation under satisfactory video-laryngoscopic view, using laryngoscopic view as a surrogate measure for successful intubation can give false assurances of device efficacy. While improvement in first-pass laryngoscopic success confers less airway trauma and possibly the prevention in deterioration to a 'Cannot Intubate Cannot Ventilate' scenario, it then translates into much more success than the improvement with multiple attempts and shortened intubation time. Meta-analyses have demonstrated that the Airtraq significantly decreased intubation time both in novice and in experienced anaesthetists compared with the Macintosh laryngoscope. Whereas in the first-attempt intubation, an increase in the first-pass success rate was only found in novice anaesthetists with significant analysis heterogeneity.

In view of these, a large pragmatic effectiveness trial using first-pass intubation success as the primary endpoint to compare the Airtraq and Macinotosh direct laryngoscope is necessary. The trial population should include normal and abnormal airways, a variety of elective and non-elective patients and proceduralists with mixed experience to allow results to be generalizable. A large trial would allow testing of subgroup effects that has not been previously possible and results would be generalizable due to its pragmatic design. The results of this trial will provide improved guidance for current airway algorithms. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT03887897
Study type Interventional
Source Chinese University of Hong Kong
Contact Matthew TV Chan, MBBS
Phone +852 91363821
Email mtvchan@cuhk.edu.hk
Status Recruiting
Phase N/A
Start date October 2, 2019
Completion date December 2022

See also
  Status Clinical Trial Phase
Completed NCT03277872 - NoL, HR and MABP Responses to Tracheal Intubation Performed With MAC Blade Versus Glidescope N/A
Suspended NCT04253795 - Nonintubated Versus Intubated Anesthesia in Video-assisted Thoracic Surgery N/A
Completed NCT02864017 - Immuno Nutrition by L-citrulline for Critically Ill Patients N/A
Completed NCT02900807 - CT-scan Airways Mensuration - Correlation to External Measurements
Completed NCT01823328 - Ketamine Versus Etomidate for Rapid Sequence Intubation Phase 4
Completed NCT02350933 - Endoscopic Evaluation of the Paediatric Airway After Prior Prolonged (>24 h) Tracheal Intubation N/A
Completed NCT01170455 - Nasal Intubation Using the Blind Intubation Device N/A
Completed NCT00980590 - Airway Scope and Macintosh Laryngoscope for Tracheal Intubation in Patients Lying on the Ground N/A
Completed NCT05515107 - The Laryngoscopic View With C-MAC Videolaryngoscope Miller Blade Lifting the Epiglottis or the Vallecula in Children N/A
Completed NCT06249659 - Impact of Extubation Location After Surgery on Perioperative Times
Completed NCT03677505 - KoMAC Videolaryngoscope for Double-lumen Intubation N/A
Completed NCT03328182 - Assessment of an Oral Endotracheal Subglottic Tube Holder N/A
Recruiting NCT02277405 - Pediatric Intubation During Resuscitation N/A
Recruiting NCT02073786 - Rigid Video Stylet Vs Conventional Lightwand Intubation N/A
Recruiting NCT02277652 - Endotracheal Intubation Devices N/A
Completed NCT02277418 - Venner a.p. Advance Video Laryngoscope N/A
Completed NCT01003327 - Comparison of the I-gel Laryngeal Mask and the Classic Laryngeal Mask in Patients With a BMI>25 Phase 4
Completed NCT00956592 - Clinical Evaluation of the Storz CMAC Laryngoscope N/A
Completed NCT00783731 - Low Dose of Midazolam is Superior to Conventional Dose for Rapid Sequence Intubation in Emergency Department (ED) N/A
Completed NCT02931019 - The Effect of Head Position on the Intubating Condition Using Fiberoptic Bronchoscopy N/A