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Paratracheal pressure may have a role in the prevention of pulmonary aspiration. The effects of paratracheal pressure on glottic view, ease of facemask ventilation, or tracheal intubation are not studied yet. In this study, the subjects are divided into two groups (group I: paratracheal pressure applied during induction of anesthesia, group II: conventional Sellick's maneuver applied during induction of anesthesia). Investigators will assess the glottic view during direct laryngoscopy.
Primary outcome:
-Cormack-Lehane grade
Secondary outcome:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Paratracheal pressure | Active Comparator | Left Paratracheal pressure is applied by ultrasound transducer after confirmation of the location of the esophagus. |
|
| Sellick's maneuver | Active Comparator | Conventional Sellick's maneuver is applied. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Paratracheal pressure | Procedure | Paratracheal pressure is applied by 30N force with the ultrasound transducer. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Cormack-Lehane grade | Cormack-Lehane grade | During anesthesia induction procedure |
| Measure | Description | Time Frame |
|---|---|---|
| POGO | The percentage of glottic opening (POGO), linear span from the anterior commissure to the interarytenoid notch, 0-100%, higher value represent a better view | During anesthesia induction procedure |
| Difficulty of mask ventilation |
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Inclusion Criteria:
Adult patient undergoing elective surgery with general anesthesia
Exclusion Criteria:
A patient who does not agree to participate in this study A patient who has a history of cervical/esophageal operation A patient who has a risk of gastric regurgitation A patient who has atherosclerosis of the left carotid artery or history of stroke or angina in 3 months.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul National University Hospital | Seoul | 07061 | South Korea | |||
| SMG - SNU Boramae Medical Center |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34081034 | Derived | Won D, Kim H, Chang JE, Lee JM, Min SW, Ma S, Kim C, Hwang JY, Kim TK. Effect of Paratracheal Pressure on the Glottic View During Direct Laryngoscopy: A Randomized Double-Blind, Noninferiority Trial. Anesth Analg. 2021 Aug 1;133(2):491-499. doi: 10.1213/ANE.0000000000005620. |
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| Sellick's maneuver | Procedure | Conventional Sellick's maneuver is applied by 30N force |
|
Difficulty of mask ventilation evaluated by the anesthesiologist (Easy/Moderate/Difficult/Impossible)
| During anesthesia induction procedure |
| Inspiration pressure | Pressure to maintain adequated ventilation after application of the intervention | During anesthesia induction procedure |
| Tidal volume | Tidal volume which is achieved after application of the intervention | During anesthesia induction procedure |
| Intubation difficulty | Subjective evaluation of the difficulty to pass the endotracheal tube into the glottic opening, easy/moderate/difficult | During anesthesia induction procedure |
| Seoul |
| 07061 |
| South Korea |