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NCT Number: NCT05974540

USG vs Palpation for Cricothyroid Membrane Determination

Emergency cricothyroidotomy is a very important technique to ensure airway safety in acute situations. Problem in identifying the cricothyroid membrane is a major contributor to high failure, as the most common complication during cricothyrotomy is the misplacement of the cannula. The success rate of emergency airway access performed by anesthesiologists and emergency medicine specialists was found to be low due to the low frequency of the procedure. The aim in this study is to compare the palpation method with the ultrasonugraphy (USG)-based method in determining the cricothyroid membrane. The hypothesis is that USG is more successful than palpation in identifying the cricothyroid membrane. In addition, the relationship between difficult intubation and measurements such as the cricothyroid membrane length, the cricoid cartilage and the skin distance, the distance between the cricoid cartilage and the second tracheal ring will be evaluated.

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Key information

Conditions

Ultrasound Cricothyroid Membrane

Age range

1 year–18 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Marmara University Department of Anesthesiology and Reanimation

Istanbul, 34912, Turkey (Türkiye)

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • American Society of Anaesthesiologists (ASA) I and II physical status
  • Elective pediatric surgery
  • Patients going to be intubated

Exclusion criteria

  • ASA III or above physical status
  • Emergency surgery
  • Patients having tracheostomy
  • Patients going to have laryngeal mask

Treatment and study plan

Determination of cricothyroid membrane

Diagnostic Test

After the patient's head is extended, the pediatric surgeon will be asked to mark the cricothyroid membrane with a pencil using traditional inspection and palpation methods. Then, the cricothyroid membrane will be determined by the Anesthesiology and Reanimation specialist by USG method and the difference will be determined. Demographic and morphometric characteristics of the patients will be recorded. In addition, the length of the cricothyroid membrane, the distance between the cricoid cartilage and the skin, the distance between the cricoid cartilage and the 2nd tracheal ring will be measured by USG.

Mallampati classes of patients with intubation, Cormack-Lehane (CL) glottic appearance grades, Likert scale with intubation difficulties (1: very easy, 2: easy, 3: medium, 4: difficult) will also be recorded.

Primary outcomes

  1. Distance between palpation-based and USG-based determination of the cricothyroid membrane

    Time frame: On the 1 day of the surgery. After the anesthesia induction and intubation.

    Regarding the determination point of the cricothyroid membrane the distance between palpation-based method performed by pediatric surgeon and USG-based method performed by anesthesiologist will be measured.

Secondary outcomes

  1. Cricothyroid membrane length

    Time frame: On the 1 day of the surgery. After the anesthesia induction and intubation.

    Cricothyroid membrane length will be measured by anesthesiologist using USG. Longitudinal view of the thyroid, cricoid and trakeal ring cartilages will be obtained and the measurement will be made.

  2. Skin distance from cricoid cartilage

    Time frame: On the 1 day of the surgery. After the anesthesia induction and intubation.

    Skin distance from cricoid cartilage will be measured by anesthesiologist using USG. Longitudinal view of the thyroid, cricoid and trakeal ring cartilages will be obtained and the measurement will be made.

  3. Distance between cricoid cartilage and 2nd tracheal ring

    Time frame: On the 1 day of the surgery. After the anesthesia induction and intubation.

    Distance between cricoid cartilage and 2nd tracheal ring will be measured by anesthesiologist using USG. Longitudinal view of the thyroid, cricoid and trakeal ring cartilages will be obtained and the measurement will be made.

Sponsors and collaborators

Lead sponsor

Marmara University

Other

Registry information

Official study title

Ultrasound Versus Physical Examination for Cricothyroid Membrane Determination in Pediatric Patients

Important dates

Study start
2023
Primary completion
2025
Study completion
2025
First posted
Aug 3, 2023
Registry last updated
Jun 4, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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