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The goal of this interventional study is to compare the effectiveness of direct laryngoscopy vs. video laryngoscopy in paediatric population aged 2 to 8 years presenting for elective surgeries having uncomplicated airways.
The primary outcome measures include:
The comparision of efficacy of Video Laryngoscopy for pediatric airway vs Direct Laryngoscopy is the goal of this study, Safety of the patients will be the utmost priority with careful case selection alongwith proper informed detailed consent from the guardians of the children.
PROCEDURE:
After induction of General Anesthesia four minutes of proper bag mask ventilation to allow for proper intubating conditions will be done. The time taken from the insertion of the laryngoscopic blade to the best glottic view acheived by the specific technique will be noted seperately and then the time to the succesful acheivement of lung inflation with the proper placement of ETT will be noted seperately, both of these parameters will be recorded.
If in a patient airway is not secured even after 3 attempts by a specific technique the technique would be altered and patient would be excluded from our research.
MATERIALS:
Randomized allotment of patients into the 2 groups i.e Direct Laryngoscopy and Video Laryngoscopy would be done.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Direct Laryngoscopy Group | Active Comparator | Group of patients in which standard direct laryngoscopy will be used to secure airway. |
|
| Video Laryngoscopy group | Active Comparator | Group of patients in which Video Laryngoscopy will be used to secure airways. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Video Laryngoscope | Device | Use of Video laryngoscope to secure airway |
| |
| Measure | Description | Time Frame |
|---|---|---|
| .Time taken to acheive the best possible view of the glottis. | The time from insertion of laryngoscope in the mouth to the best possible view of the glottis. | 4 Min. post muscle relaxant administration to 6 Min. post muscle relaxant administration |
| Time taken to acheive succesful Endotracheal Intubation. | The time from the insertion of the laryngoscopic blade in the mouth to the correct placement of ETT confirmed by the waveform capnorgraphy. | 4 Min 30 seconds post muscle relaxant administration to 7 Min post muscel relaxant administration. |
| No. of Intubation attempts needed | Total No. of attempts(max 3 attempts with the same technique) to secure airway. | 4 Min. post muscle relaxation administration to 15 Min. post muscle relaxant administration. |
| Measure | Description | Time Frame |
|---|---|---|
| Hemodynamic changes at different intervals. | Changes in heart rate will be assesed during attempts and to a fixed amount of time after succesfully securing the airways. | During attempts to 1 min, 5 min, and 10 min post succesful intubation. |
| Hemodynamic changes at different intervals. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Muhammad Ilyas, FCPS,MBBS | Contact | 03007355742 | med-spec@hotmail.com | |
| Muhammad Munim Ilyas, MBBS | Contact | 03335642984 | munim_95@hotmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Combined Millitary Hospital | Rawalpindi | Punjab Province | 46000 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24288617 | Background | Rabiner JE, Auerbach M, Avner JR, Daswani D, Khine H. Comparison of GlideScope Videolaryngoscopy to Direct Laryngoscopy for Intubation of a Pediatric Simulator by Novice Physicians. Emerg Med Int. 2013;2013:407547. doi: 10.1155/2013/407547. Epub 2013 Oct 31. | |
| 27293429 | Background | Sinha R, Sharma A, Ray BR, Kumar Pandey R, Darlong V, Punj J, Chandralekha C, Upadhyay AD. Comparison of the Success of Two Techniques for the Endotracheal Intubation with C-MAC Video Laryngoscope Miller Blade in Children: A Prospective Randomized Study. Anesthesiol Res Pract. 2016;2016:4196813. doi: 10.1155/2016/4196813. Epub 2016 May 15. |
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The outcomes of the study will be shared eventually once concluded
Undecided
not yet Decided
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Comparitive study between 2 groups.
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Participants are not aware of the method which will be used to secure their airway.
| Direct laryngoscope |
| Device |
Macintosh or Miller's laryngoscopes used to secure paediatric airways |
|
Changes in blood pressure will be assesed during attempts and to a fixed amount of time after succesfully securing the airways. |
| During attempts to 1 min, 5 min, and 10 min post succesful intubation. |
| 35497693 | Background | Myatra SN, Patwa A, Divatia JV. Videolaryngoscopy for all intubations: Is direct laryngoscopy obsolete? Indian J Anaesth. 2022 Mar;66(3):169-173. doi: 10.4103/ija.ija_234_22. Epub 2022 Mar 24. No abstract available. |
| 32850555 | Background | Zhou M, Xi X, Li M, Wang S, Liu Z, Liu JQ. Video Laryngoscopy Improves the Success of Neonatal Tracheal Intubation for Novices but Not for Experienced Medical Staff. Front Pediatr. 2020 Aug 6;8:445. doi: 10.3389/fped.2020.00445. eCollection 2020. |