Standard vs flexible tip bougie for videolaryngoscopy

  • Research type

    Research Study

  • Full title

    A randomised comparison between standard and flexible tip bougie (tracheal tube introducers) for tracheal intubation using non channelled videolaryngoscopes

  • IRAS ID

    287767

  • Contact name

    Cyprian Mendonca

  • Contact email

    Cyprian.mendonca@uhcw.nhs.uk

  • Sponsor organisation

    University Hospitals of Coventry and Warwickshire

  • Clinicaltrials.gov Identifier

    NCT04973176

  • Duration of Study in the UK

    1 years, 5 months, 30 days

  • Research summary

    When providing a general anaesthetic to a patient, a breathing tube is often inserted into the windpipe to assist or control the patients’ breathing. A breathing tube correctly placed in the windpipe is the most secure airway. The process of placing the breathing tube in the windpipe is called as intubation. Traditionally this was done using direct laryngoscope (battery operated metal blade). The traditional laryngoscope provides a direct view of the vocal cords (the entrance to the windpipe).

    In recent years videolaryngoscopes - devices with a camera built into the tip of the blades have been increasingly used and considered as standard of care in anaesthesia.
    Videolaryngoscopes provide an indirect view of vocal cords on the monitor screen. Because the view is not direct and the breathing tube often has to be inserted around a curved passage, a tube introducer (bougie) is required to assist placement of the breathing tube. These are long thin devices which are stiff but able to be bent into shape. The standard bougie has a forward facing rigid angled tip. The forward-facing tip facilitates the passage of tip up to the vocal cords. But soon after passing through the vocal cords it gets stuck at the entrance of windpipe. Therefore, the breathing fails to advance further into the windpipe.

    A recently introduced flexible tip bougie likely to overcome this problem. The tip can be flexed forward initially till it enters through the vocal cords, then it can be flexed backwards or straightened so that it can be advance bit further to facilitate the passage of breathing tube.

    We wish to compare the flexible tip bougie with a standard bougie. We hypothesise that with videolaryngoscopes, the flexible tip bougie will improve the success of tracheal intubation. We measure this using a score known as modified intubation difficulty scale score.

  • REC name

    West Midlands - Coventry & Warwickshire Research Ethics Committee

  • REC reference

    21/WM/0123

  • Date of REC Opinion

    28 Jun 2021

  • REC opinion

    Further Information Favourable Opinion