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Direct laryngoscope is a standard equipment for endotracheal intubation. To identify the differences between Macintosh size 3 and 2 blades, we will analysis the data collected from airway and intubation condition.
Selection the most appropriate size of laryngoscope blade size could not only increased intubation successful rate at the first time but also decrease the incidence of tissue trauma. Laryngoscope blade used in daily practice is usually Macintosh 3. However, compared with Caucasian people, Asian people are smaller and thinner especially in women. This study aims to confirm that the Macintosh 2 blade is not inferior to size 3 blade in laryngeal view and intubation rate.
Female patients without known difficult airway will be enrolled and allocated into Macintosh blade size 2 and size 3 groups. The age, body weight, body height, Mallampati classification, mouth opening, thyromental distance, neck circumference, intubation time, Cormack-Lehane grade, intubation difficulty scale scores and associated teeth or tissue traumas will be recorded.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Macintosh 2 group | Experimental | Using Macintosh size 2 blade for direct laryngoscope intubation according to randomization |
|
| Macintosh 3 group | Active Comparator | Using Macintosh size 3 blade for direct laryngoscope intubation according to randomization |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Macintosh size 2 blade | Device | intubate with Macintosh size 2 blade |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Intubation time | Time from laryngoscope insertion to the first adequate lung insufflation | 0-10 minutes during induction |
| Cormack-Lehane grade | Classification of glottis view during intubation | 0-10 minutes during induction |
| Intubation difficulty scale scores | Scoring system to assess the difficulty of intubation in each patient | 0-10 minutes during induction |
| Tissue trauma | Any tissue trauma event related to intubation | 0-10 minutes during induction |
| Teeth trauma | Any dental damage event related to intubation | 0-10 minutes during induction |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Nuan-Yen Su, MS | Mackay Memorial hospital, department of anesthesiology, attending physician | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mackay Memorial Hospital | Taipei | Taiwan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 16651910 | Background | Mellick LB, Edholm T, Corbett SW. Pediatric laryngoscope blade size selection using facial landmarks. Pediatr Emerg Care. 2006 Apr;22(4):226-9. doi: 10.1097/01.pec.0000210171.17892.7a. | |
| 19593148 | Background | Ashfaque M, Mason J, Al-Shaikh B, Adegoke K. A comparison of the Laryngopharyngeal Examination blade and the English Macintosh laryngoscope blade using an intubating manikin: a prospective randomized crossover study. Eur J Anaesthesiol. 2009 Nov;26(11):917-22. doi: 10.1097/EJA.0b013e32832c7848. |
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| Macintosh size 3 blade |
| Device |
intubate with Macintosh size 3 blade |
|
| 12644417 | Background | Asai T, Matsumoto S, Fujise K, Johmura S, Shingu K. Comparison of two Macintosh laryngoscope blades in 300 patients. Br J Anaesth. 2003 Apr;90(4):457-60. doi: 10.1093/bja/aeg086. |
| 7943768 | Background | Watanabe S, Suga A, Asakura N, Takeshima R, Kimura T, Taguchi N, Kumagai M. Determination of the distance between the laryngoscope blade and the upper incisors during direct laryngoscopy: comparisons of a curved, an angulated straight, and two straight blades. Anesth Analg. 1994 Oct;79(4):638-41. doi: 10.1213/00000539-199410000-00004. |