Modified Laryngeal Handshake Technique

Modified Laryngeal Handshake Technique for Locating the Cricothyroid Membrane

In this study, we compare the conventional laryngeal handshake technique and modified laryngeal handshake technique for locating the cricothyroid membrane in terms of accuracy and speed. The conventional laryngeal handshake technique is performed with the non-dominant hand, identifying the hyoid bone and thyroid laminae, stabilizing the larynx between thumb and middle finger, and moving down the neck to palpate the cricothyroid membrane with the index finger.

The modified laryngeal handshake is performed with the non-dominant hand, stabilizing the trachea between thumb and middle finger from the suprasternal notch and moving up the neck to palate the cricoid cartilage and cricothyroid membrane with the index finger.

Study Overview

• Status: Completed
• Conditions: Airway Complication of Anesthesia
• Intervention / Treatment: Procedure: Conventional laryngeal handshake technique; Procedure: Modified laryngeal handshake technique

• Study Type: Interventional
• Enrollment (Actual): 200
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Korea, Republic of
  • Seoul, Korea, Republic of
    • SMG-SNU Boramae Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years and older (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• Patients who would be scheduled elective surgery under general anesthesia

Exclusion Criteria:

• Diseases or anatomical abnormalities in the neck or larynx
• History of neck surgery

Study Plan

How is the study designed?

Design Details

• Primary Purpose: DIAGNOSTIC
• Allocation: RANDOMIZED
• Interventional Model: PARALLEL
• Masking: DOUBLE

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
ACTIVE_COMPARATOR: Conventional laryngeal handshake technique; The conventional laryngeal handshake technique is performed to localize the cricothyroid membrane	Procedure: Conventional laryngeal handshake technique; The conventional laryngeal handshake technique is performed with the non-dominant hand, identifying the hyoid bone and thyroid laminae, stabilizing the larynx between thumb and middle finger, and moving down the neck to palpate the cricothyroid membrane with the index finger.
EXPERIMENTAL: Modified laryngeal handshake technique; The modified laryngeal handshake is performed to localize the cricothyroid membrane	Procedure: Modified laryngeal handshake technique; The modified laryngeal handshake is performed with the non-dominant hand, stabilizing the trachea between thumb and middle finger from the suprasternal notch and moving up the neck to palate the cricoid cartilage and cricothyroid membrane with the index finger.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The accuracy to localize the cricothyoid membrane	The accuracy of the cricothyroid membrane identified by the conventional and modified handshake techniques are evaluated.	1 minute after identifying the cricothyroid membrane using the conventional or modified laryngeal handshake technique

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The accuracy to localize the midline of the neck	The accuracy of the midline of the neck identified by the conventional and modified handshake techniques are evaluated.	through the identification of cricothyroid membrane, an average of 5 minutes
The vertical and horizontal distances between the actual and perceived cricothyroid membrane	The vertical and horizontal distances between the actual and perceived cricothyroid membrane using the conventional and modified handshake techniques are evaluated.	through the identification of cricothyroid membrane, an average of 5 minutes
Time to localize the cricothyroid membrane	The time taken to identify the cricothyroid membrane is recorded.	through the identification of cricothyroid membrane, an average of 5 minutes

Collaborators and Investigators

• Sponsor: SMG-SNU Boramae Medical Center
• Investigators: Principal Investigator: Jin-Young Hwang, MD, PhD, SMG-SNU Boramae Medical Center

Publications and helpful links

General Publications

• Chang JE, Kim H, Won D, Lee JM, Kim TK, Min SW, Hwang JY. Comparison of the Conventional Downward and Modified Upward Laryngeal Handshake Techniques to Identify the Cricothyroid Membrane: A Randomized, Comparative Study. Anesth Analg. 2021 Nov 1;133(5):1288-1295. doi: 10.1213/ANE.0000000000005744.

Study record dates

Study Major Dates

• Study Start (ACTUAL): March 5, 2020
• Primary Completion (ACTUAL): November 30, 2020
• Study Completion (ACTUAL): November 30, 2020

Study Registration Dates

• First Submitted: August 21, 2019
• First Submitted That Met QC Criteria: August 21, 2019
• First Posted (ACTUAL): August 22, 2019

Study Record Updates

• Last Update Posted (ACTUAL): January 28, 2021
• Last Update Submitted That Met QC Criteria: January 25, 2021
• Last Verified: January 1, 2021

More Information

Terms related to this study

• Other Study ID Numbers: 2019208

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No