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Trial registered on ANZCTR
Registration number
ACTRN12619001034123
Ethics application status
Approved
Date submitted
19/06/2019
Date registered
19/07/2019
Date last updated
10/12/2019
Date data sharing statement initially provided
19/07/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
A comparison of two intubation aids in the management of anticipated difficult tracheal intubation
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Scientific title
Flexible Tip Bougie versus C-MAC Stylet in the management of anticipated difficult intubation in patients undergoing elective surgery. A pilot study
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Secondary ID [1]
298460
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None
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Universal Trial Number (UTN)
U1111-1235-0991
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Difficult Intubation
313218
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Condition category
Condition code
Anaesthesiology
311667
311667
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0
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Other anaesthesiology
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Respiratory
311927
311927
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The Construct Medical Flexible Tip Bougie (the intervention) will be used to assist with intubation in patients requiring videolaryngoscopy with a CMAC D-Blade.
The Construct Medical Flexible Tip Bougie is an alternative tool, also designed to overcome the "can see, can’t intubate" scenario. This device incorporates a slider, controlled with the thumb and the forefinger, to guide the tip anteriorly, guiding it through the glottis. Furthermore, the ability to also flex the tip posteriorly once past the vocal cords, may avoid the problem of the ETT hitting the anterior tracheal wall and impeding passage of the tube. , Once manipulated into position, the ETT is passed over the bougie, into the trachea.
The intubation will be performed by an anaesthetist with at least 3 years anaesthesia experience. A single intubation will be performed for each recruited patient, following the induction anaesthesia.
Details of whether or not the patient was successfully intubated with the allocated device will be collected on the case report form, including which, if any, additional airway devices were required.
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Intervention code [1]
314703
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Treatment: Devices
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Comparator / control treatment
The GlideRite Rigid Stylet (the comparator) will be used to assist with intubation in patients requiring videolaryngoscopy with a CMAC D-Blade
The GlideRite® Rigid Stylet has been shown to reduce time to successful intubation with a D-blade videolaryngoscope and is currently the standard intubation introducer used with the D-Blade at Sir Charles Gairdner Hospital. The curve of the stylet matches the curvature of the D-blade, and the ETT is pre-loaded over the stylet. Unlike the flexible-top bougie there is no ability to manipulate the direction or curvature of the device mid-intubation.
As with the flexible tip bougie, the intubation will be performed by an anaesthetist with at least 3 years anaesthesia experience. A single intubation will be performed for each recruited patient, following the induction anaesthesia.
Details of whether or not the patient was successfully intubated with the allocated device will be collected on the case report form, including which, if any, additional airway devices were required.
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Control group
Active
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Outcomes
Primary outcome [1]
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Time taken to successful intubation.
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Assessment method [1]
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Timepoint [1]
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Single time point for each patient. Successful intubation defined as the time from anaesthetist first taking hold of the introducer, to confirmation of successful intubation by visualisation of a capnography trace on the monitor
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Secondary outcome [1]
371704
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Number of intubation attempts required, recorded on case report form by the intubating anaesthetist
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Assessment method [1]
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Timepoint [1]
371704
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At time of intubation
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Secondary outcome [2]
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Additional adjuncts required to achieve successful intubation (Y/N). This will be reported by the intubating anaesthetist on the case report form following successful intubation
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Assessment method [2]
371705
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Timepoint [2]
371705
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At time of intubation
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Secondary outcome [3]
371706
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Anaesthetist rated ease of use of device: recorded on a Likert scale (1-5) by intubating anaesthetist
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Assessment method [3]
371706
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Timepoint [3]
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Following successful intubation
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Eligibility
Key inclusion criteria
• Adults (>18years) able to provide informed consent
• Booked for elective, non-cardiac surgery
• Presence of at least one predictor of increased difficulty of intubation
(Any of: prior history of difficult intubation, thyromental distance (<6cm), mouth opening (<2cm), decreased neck extension, Mallampati grade 3+, decreased jaw protrusion)
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
• Age under 18 years
• Unable to give informed consent to participate
• Would not routinely require routine endotracheal intubation for the surgical procedure
• Known disease of airway (tumour, infection, tracheal stenosis, tracheomalacia)
• Recent airway surgery (within 6 weeks)
• Difficult airway necessitating awake intubation
• Allergy to fentanyl, propofol or rocuronium
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Online computerised sequence generation (sealedenvelope.com),
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Standard biographical data and surgical information for each group will be compared with descriptive statistics. Comparison of means and standard deviations of groups. Given the nature of this pilot study no inferential statistical analysis will be performed. No interim analysis is planned
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
29/07/2019
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Actual
29/07/2019
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Date of last participant enrolment
Anticipated
30/08/2019
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Actual
2/09/2019
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Date of last data collection
Anticipated
30/09/2019
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Actual
2/09/2019
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Sample size
Target
40
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Accrual to date
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Final
40
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
14015
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Sir Charles Gairdner Hospital - Nedlands
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Recruitment postcode(s) [1]
26800
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6009 - Nedlands
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Funding & Sponsors
Funding source category [1]
303003
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Hospital
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Name [1]
303003
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Sir Charles Gairdner Hospital
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Address [1]
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Hospital Avenue, NEDLANDS, WA, 6009
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Country [1]
303003
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Australia
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Primary sponsor type
Hospital
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Name
Sir Charles Gairdner Hospital
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Address
Hospital Avenue, NEDLANDS, WA, 6009
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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N/A
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Address [1]
302971
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N/A
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Country [1]
302971
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
303553
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Sir Charles Gairdner and Osborne Park Health Care Group Human Research Ethics Committee
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Ethics committee address [1]
303553
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SCGOPHCG - ARC 2nd Floor A Block Hospital Avenue NEDLANDS Western Australia 6009
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Ethics committee country [1]
303553
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Australia
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Date submitted for ethics approval [1]
303553
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Approval date [1]
303553
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12/09/2018
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Ethics approval number [1]
303553
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Summary
Brief summary
In patients in whom intubation of the airway is predicted to be difficult, a C-MAC D-blade videolaryngoscope™ (Karl Storz Endoscopy, Tuttlingen, Germany) is commonly used to improve visualisation of the Glottis. Due to the high angulation of the D-Blade it is not uncommon to encounter a "can see, cannot intubate" situation, This study will compare the intubation times of two airway adjuncts used with the CMAC D-blade - the Construct Medical Flexible Tip Bougie, and the GlideRite rigid stylet, We hypothesise that the flexible tip bougie will offer improved speed of intubation owing to its ability to adjust the direction of the bougie tip during the intubation.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
94062
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Dr Dale Currigan
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Address
94062
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Department of Anaesthesia
Sir Charles Gairdner Hospital
Hospital Avenue, Nedlands, WA, 6009
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Country
94062
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Australia
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Phone
94062
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+61864573333
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Fax
94062
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Email
94062
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[email protected]
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Contact person for public queries
Name
94063
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Dale Currigan
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Address
94063
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Department of Anaesthesia
Sir Charles Gairdner Hospital
Hospital Avenue, Nedlands, WA, 6009
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Country
94063
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Australia
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Phone
94063
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+61864573333
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Fax
94063
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Email
94063
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[email protected]
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Contact person for scientific queries
Name
94064
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Dale Currigan
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Address
94064
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Department of Anaesthesia
Sir Charles Gairdner Hospital
Hospital Avenue, Nedlands, WA, 6009
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Country
94064
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Australia
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Phone
94064
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+61864573333
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Fax
94064
0
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Email
94064
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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