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Effect Of Left Head Rotation On Glottic View During Video Laryngoscopy In Obese Adults (LeHeR)

8. maj 2026 opdateret af: Kalesh Divakar, Royal Hospital, Oman

Effect of Left Head Rotation Manoeuvre on Glottic View as Assessed With Percentage of Glottic Opening (POGO) Score During Video Laryngoscopy in Obese Adult Patients: A Prospective Observational Study

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.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Undersøgelsestype

Observationel

Tilmelding (Anslået)

50

Kontakter og lokationer

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Deltagelseskriterier

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Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

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Ja

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

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.

Beskrivelse

Inclusion Criteria

  • 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

Exclusion Criteria:

  • Anticipated need for nasal intubation
  • Facial or upper airway pathology preventing laryngoscope insertion
  • Cervical spine instability or contraindication to head movement
  • Pregnant patients

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in Percentage of Glottic Opening (POGO) Score between Sniffing Position and Left Head Rotation
Tidsramme: Baseline during induction of anaesthesia at the time of video laryngoscopy on Day 1 (single intra-operative assessment)
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.
Baseline during induction of anaesthesia at the time of video laryngoscopy on Day 1 (single intra-operative assessment)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Time to Successful Intubation
Tidsramme: During induction of anesthesia on Day 1
Time taken from insertion of the video laryngoscope blade into the oral cavity until successful placement of the endotracheal tube confirmed by capnography.
During induction of anesthesia on Day 1
Ease of Intubation
Tidsramme: During tracheal intubation on Day 1
Ease of intubation assessed using Fremantle score as easy, modified, or unachievable based on number of attempts and need for adjuncts.
During tracheal intubation on Day 1
Number of Intubation Attempts
Tidsramme: During tracheal intubation on Day 1
Number of attempts required to achieve successful tracheal intubation.
During tracheal intubation on Day 1
Requirement of Airway Adjuncts
Tidsramme: During tracheal intubation on Day 1
Need for additional maneuvers such as external laryngeal manipulation, cuff inflation, or use of Magill forceps during intubation.
During tracheal intubation on Day 1
Incidence of Peri-intubation Complications
Tidsramme: During induction of anesthesia and tracheal intubation on day 1
Occurrence of complications such as oxygen desaturation (SpO₂ <95%) or airway trauma during intubation.
During induction of anesthesia and tracheal intubation on day 1

Samarbejdspartnere og efterforskere

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Sponsor

Royal Hospital, Oman

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. maj 2026

Primær færdiggørelse (Anslået)

1. december 2026

Studieafslutning (Anslået)

1. januar 2027

Datoer for studieregistrering

Først indsendt

30. april 2026

Først indsendt, der opfyldte QC-kriterier

8. maj 2026

Først opslået (Faktiske)

15. maj 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

15. maj 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

8. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • MoH/CSR/26/31800

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

Individual participant data will not be shared due to institutional policies and to ensure protection of participant confidentiality. Data may be made available upon reasonable request to the corresponding author, subject to institutional review and approval.

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