This study compares two videolaryngoscope blade designs for nasal tracheal intubation in patients undergoing surgery under general anesthesia. Participants will be randomly assigned to undergo nasal tracheal intubation using either a hyperangulated C-MAC® D-BLADE® or a Macintosh-style videolaryngoscope blade.
The study will evaluate the effectiveness of each approach by measuring time to successful intubation, number of intubation attempts, airway maneuvers required, and other procedural outcomes. Safety outcomes, including airway- and anesthesia-related adverse events, will also be assessed. The findings may help identify the most effective and safe videolaryngoscope blade design for nasal tracheal intubation.
None
Patients requiring awake fiber optic intubation
Emergency cases
High risk of aspiration
Bleeding diathesis
Parallel
C-MAC® Videolaryngoscope D-BLADE®
DeviceThe C-MAC® Videolaryngoscope D-BLADE® is a hyperangulated videolaryngoscope blade used for nasal tracheal intubation. Participants randomized to this intervention will undergo their initial study intubation attempt using the assigned D-BLADE® following induction of general anesthesia.
C-MAC® Videolaryngoscope Macintosh Blade
DeviceThe C-MAC® Videolaryngoscope Macintosh Blade is a Macintosh-style videolaryngoscope blade used for nasal tracheal intubation. Participants randomized to this intervention will undergo their initial study intubation attempt using a size 3 or size 4 Macintosh blade, as clinically appropriate, following induction of general anesthesia.
The incidence of adjunct maneuvers for nasal intubation.
Time from insertion of the videolaryngoscope blade into the mouth to confirmation of successful tracheal intubation by three consecutive end-tidal carbon dioxide waveforms.
First-pass success rate
The proportion of participants in whom successful nasal tracheal intubation is achieved on the first intubation attempt.
Total time for intubation
The total time required to achieve successful nasal tracheal intubation, measured from insertion of the videolaryngoscope blade into the mouth to confirmation of successful intubation by three consecutive end-tidal carbon dioxide waveforms.
Number of adjunct maneuvers required for successful nasal intubation
The number and type of adjunct maneuvers required to achieve successful nasal tracheal intubation, including maneuvers such as tube rotation, external laryngeal manipulation, head positioning, cuff insufflation, use of McGill forceps, bougie use, or other documented techniques.
Total number of intubation attempts
The total number of intubation attempts required to achieve successful nasal tracheal intubation. Each insertion of the videolaryngoscope blade will be considered one intubation attempt.
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