Effect Of Left Head Rotation On Glottic View During Video Laryngoscopy In Obese Adults
Trial statusNot yet recruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age18-65
SponsorRoyal Hospital, Oman
About this trial
This study aims to evaluate whether the Left Head Rotation (LeHeR) maneuver improves visualization of the vocal cords during video laryngoscopy in obese adult patients undergoing general anesthesia. Obesity is associated with increased difficulty in airway management due to excess upper airway soft tissue and altered anatomy, which may impair visualization during intubation.
In this prospective observational study, 50 adult patients with a body mass index (BMI) ≥30 kg/m² will undergo video laryngoscopy using a C-MAC D-blade. The glottic view will be assessed using the Percentage of Glottic Opening (POGO) score in the standard sniffing position and after rotating the head 45 degrees to the left (LeHeR maneuver). A difference in POGO score between the two positions will be analyzed.
Secondary outcomes include ease of intubation, number of attempts, time to successful intubation, and occurrence of complications such as desaturation or airway trauma. The study is expected to determine whether the LeHeR maneuver is a simple and effective technique to improve airway visualization in obese patients.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Adult patients aged 18-65 years
Body mass index (BMI) ≥30 kg/m²
ASA physical status I-III
Scheduled for elective surgical procedures under general anesthesia requiring endotracheal intubation
Disqualifiers
Anticipated need for nasal intubation
Facial or upper airway pathology preventing laryngoscope insertion
Cervical spine instability or contraindication to head movement
Pregnant patients
Trial population
Adult patients aged 18-65 years with body mass index (BMI) ≥30 kg/m², classified as ASA physical status II-III, undergoing elective surgical procedures under general anesthesia requiring orotracheal intubation at a tertiary care hospital.
Trial design
Design model
Case-control
Time perspective
Prospective
Treatments tested in this trial
Not listed
Trial groups
No trial groups listed
Trial outcomes
Primary outcomes
1
Change in Percentage of Glottic Opening (POGO) Score between Sniffing Position and Left Head Rotation
The Percentage of Glottic Opening (POGO) score will be assessed during video laryngoscopy in the sniffing position and after 45-degree left head rotation (LeHeR maneuver). The difference in POGO score between the two positions will be recorded for each participant.
Time frame
Baseline during induction of anaesthesia at the time of video laryngoscopy on Day 1 (single intra-operative assessment)Secondary outcomes
1
Time to Successful Intubation
Time taken from insertion of the video laryngoscope blade into the oral cavity until successful placement of the endotracheal tube confirmed by capnography.
Time frame
During induction of anesthesia on Day 12
Ease of Intubation
Ease of intubation assessed using Fremantle score as easy, modified, or unachievable based on number of attempts and need for adjuncts.
Time frame
During tracheal intubation on Day 13
Number of Intubation Attempts
Number of attempts required to achieve successful tracheal intubation.
Time frame
During tracheal intubation on Day 14
Requirement of Airway Adjuncts
Need for additional maneuvers such as external laryngeal manipulation, cuff inflation, or use of Magill forceps during intubation.
Time frame
During tracheal intubation on Day 1Locations
Sponsors and contacts
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Source ClinicalTrials.gov
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