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| ID | Type | Description | Link |
|---|---|---|---|
| 2013-A01308-37 | Other Identifier | ANSM |
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Videolaryngoscopes become widely used. The aim of this study is to compare anesthetic induction when patients are tracheally intubated using a MacGraph Mac videolaryngoscope or a conventional MacIntosh laryngoscope.
Tracheal intubation induces a nociceptive stimulation. Hypothesis is that the use of a videolaryngoscope induces a less pronounced nociceptive stimulation and, consequently, that it modifies the anesthetic drugs requirement. .
All patients will received a standardized anesthetic procedure : combined closed-loop anesthesia system using bispectral index as control variable and two proportional-differential control algorithms, a propofol and a remifentanil target-controlled infusion system. The effectiveness of such a closed-loop anesthesia system has been demonstrated in a prospective, randomized study.
Patients will be randomized in two groups : intubation using a conventional MacIntosh laryngoscope or intubation using a videolaryngoscope.
If our hypothesis is confirmed, the required concentration of remifentanil, an opioid agent, will be reduced in the group using a videolaryngoscope.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Macintosh laryngoscope | Active Comparator | Tracheal intubation will be performed using a Macintosh laryngoscope. All patients will received propofol and remifentanil anesthesia. |
|
| McGrath Mac videolaryngoscope | Experimental | Tracheal intubation will be performed using a McGrath Mac videolaryngoscope. All patients will received propofol and remifentanil anesthesia. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tracheal intubation | Procedure | Tracheal intubation will be performed using a Macintosh laryngoscope or a McGrath Mac videolaryngoscope |
|
| Measure | Description | Time Frame |
|---|---|---|
| Required dose of opioid to counteract nociceptive stimulation | Tracheal intubation induces a nociceptive stimulation. Hypothesis is that the use of a videolaryngoscope induces a less pronounced nociceptive stimulation and, consequently, that the required maximal concentration of remifentanil is lower than when a standard laryngoscope is used. | 1 hour |
| Measure | Description | Time Frame |
|---|---|---|
| Characteristics of anesthesia | Peak concentration of propofol | one hour |
| Characteristics of anesthesia | doses of propofol and of remifentanil (from beginning of the induction to 5 minutes after tracheal intubation) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Michel Chandon, MD | Hopital Foch | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Institut Hospitalier Franco-Britannique | Levallois-Perret | Hauts de Seine | 92300 | France | ||
| Hopital Foch |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21233500 | Background | Liu N, Chazot T, Hamada S, Landais A, Boichut N, Dussaussoy C, Trillat B, Beydon L, Samain E, Sessler DI, Fischler M. Closed-loop coadministration of propofol and remifentanil guided by bispectral index: a randomized multicenter study. Anesth Analg. 2011 Mar;112(3):546-57. doi: 10.1213/ANE.0b013e318205680b. Epub 2011 Jan 13. | |
| 28930848 |
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| ID | Term |
|---|---|
| D007442 | Intubation, Intratracheal |
| D015742 | Propofol |
| ID | Term |
|---|---|
| D058109 | Airway Management |
| D013812 | Therapeutics |
| D007440 | Intubation |
| D008919 | Investigative Techniques |
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| Propofol and remifentanil anesthesia | Drug | The standardized anesthetic procedure used a closed-loop anesthesia system with bispectral index as control variable and with two proportional-differential control algorithms, one for propofol target-controlled infusion system and one for remifentanil target-controlled infusion system. |
|
| one hour |
| Characteristics of anesthesia | values of bispectral index (from beginning of the induction to 5 minutes after tracheal intubation) | one hour |
| Characteristics of tracheal intubation | time to obtain the first capnogram | one hour |
| Characteristics of tracheal intubation | visualization of the glottis (score of Cormak and Lehane modified by Yentis, POGO score | one hour |
| Characteristics of tracheal intubation | use of alternative techniques for intubation | one hour |
| Characteristics of tracheal intubation | esophageal intubation | one hour |
| Characteristics of tracheal intubation | incidence of arterial oxygen desaturation (SpO2 <92%) | one hour |
| Characteristics of tracheal intubation | hemodynamic effects of induction and tracheal intubation | one hour |
| Complications of intubation | Throat pain and hoarseness | one day |
| Ergonomic evaluation of the device | questionnaire Qusi | one hour |
| Suresnes |
| Hauts de Seine |
| 92151 |
| France |
| Ing R, Liu N, Chazot T, Fessler J, Dreyfus JF, Fischler M, Le Guen M. Nociceptive stimulation during Macintosh direct laryngoscopy compared with McGrath Mac videolaryngoscopy: A randomized trial using indirect evaluation using an automated administration of propofol and remifentanil. Medicine (Baltimore). 2017 Sep;96(38):e8087. doi: 10.1097/MD.0000000000008087. |
| D010636 |
| Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |