Evidence map›Paper›PMID 32552691›Full record

Trial reportBMC anesthesiology2020

Modified-ramped position: a new position for intubation of obese females: a randomized controlled pilot study.

Ahmed Hasanin, Hager Tarek, Maha M A Mostafa, Amany Arafa, Ahmed G Safina, Mona H Elsherbiny, Osama Hosny, Ahmed A Gado, Tarek Almenesey, Ghada Adel Hamden and 2 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC anesthesiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03640442 (Modified Ramped Position for Intubation of Obese Females), which is not on this map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03640442 nacompletednot on this map

Modified Ramped Position for Intubation of Obese Females: a Randomized Controlled Study

TypeinterventionalSponsorCairo UniversityRan2018 to 2019Enrolled60ConditionsObesity, AnesthesiaArmsModified ramped position, Ramped position
3 · Its place in the literature

Who cites it

12 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
  4. Article
  5. Article
  6. Review
  7. Article
  8. Review
  9. Observational
  10. Article
  11. Review
  12. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Ahmed HasaninDepartment of anesthesia and critical care medicine, Cairo university, Giza, Egypt. ahmedmohamedhasanin@gmail.com.ORCID 0000-0001-9947-5863
Hager TarekDepartment of anesthesia and critical care medicine, Cairo university, Giza, Egypt.
Maha M A MostafaDepartment of anesthesia and critical care medicine, Cairo university, Giza, Egypt.
Amany ArafaDepartment of anesthesia and critical care medicine, Cairo university, Giza, Egypt.
Ahmed G SafinaDepartment of surgery, Cairo university, Giza, Egypt.
Mona H ElsherbinyDepartment of anesthesia and critical care medicine, Cairo university, Giza, Egypt.
Osama HosnyDepartment of anesthesia and critical care medicine, Cairo university, Giza, Egypt.
Ahmed A GadoDepartment of anesthesia and critical care medicine, Cairo university, Giza, Egypt.
Tarek AlmeneseyDepartment of anesthesia and critical care medicine, Beni suef university, Beni suef, Egypt.
Ghada Adel HamdenDepartment of anesthesia and critical care medicine, Cairo university, Giza, Egypt.
Mohamed MahmoudDepartment of anesthesia and critical care medicine, Cairo university, Giza, Egypt.
Sarah AminDepartment of anesthesia and critical care medicine, Cairo university, Giza, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEndotracheal intubation requires optimum position of the head and neck. In obese females, the usual ramped position might not provide adequate intubating conditions. We hypothesized that a new position, termed modified-ramped position, during induction of anesthesia would facilitate endotracheal intubation through bringing the breasts away from the laryngoscope and would also improve the laryngeal visualization.

methodsSixty obese female patients scheduled for general anesthesia were randomly assigned into either ramped or modified-ramped position during induction of anesthesia. In the ramped position (n = 30), the patient head and shoulders were elevated to achieve alignment of the sternal notch and the external auditory meatus; while in the modified-ramped position (n = 30), the patient shoulders were elevated using a special pillow, and the head was extended to the most possible range. Our primary outcome was the incidence of failed laryngoscopic insertion in the oral cavity (the need for patient repositioning). Other outcomes included time till vocal cord visualization, time till successful endotracheal intubation, difficulty of the mask ventilation, and Cormack-Lehane grade for laryngeal view.

resultsFourteen patients (47%) in ramped group required repositioning to facilitate introduction of the laryngoscope in the oral cavity in comparison to one patient (3%) in the modified-ramped position (p < 0.001). Modified-ramped position showed lower incidence of difficult mask ventilation, shorter time for glottic visualization, and shorter time for endotracheal tube insertion compared to the ramped position. The Cormack-Lehane grade was better in the modified-ramped position.

conclusionModified-ramped position provided better intubating conditions, improved the laryngeal view, and eliminated the need for repositioning of obese female patients during insertion of the laryngoscope compared to ramped position. CLINICAL

trial registrationIdentifier: NCT03640442. Date: August 2018.

Indexed as

ObesityPatient PositioningAdultFemaleHumansIntubation, IntratrachealMiddle AgedPilot ProjectsFemaleLaryngoscopyModified-ramped positionObeseRamped position

Identifiers

PMID32552691
PMCPMC7298754

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.