Interaction Between Head/Neck Position and C-MAC Blade Geometry on Videolaryngoscopic Intubation in Morbidly Obese Patients: A Randomized Controlled Trial

NCT07636746 — Not applicable, Active not recruiting, 140 participants, Ain Shams University

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Registry	NCT07636746, acronym C-MAC
Status	Active not recruiting
Phase	Not applicable
Study type	Interventional; randomized, parallel, masking: quadruple, other
Enrollment	140 (Estimated)
Sponsor	Ain Shams University (Other)
Conditions	Morbid Obesity
Interventions	Sniffing position and using MAC blade., Ramped position and MAC Blade, videolaryngoscopy, videolaryngosopy (Device)
Dates	start 2026-04-17, primary completion 2026-09-20 (estimated), completion 2026-11-01 (estimated), first posted 2026-06-09, last updated 2026-06-09
Locations	1 site in Egypt

-Summary

This study aims to explore the effect of head/neck position (sniffing vs ramped) and C-MAC blade geometry (MAC vs D-blade) on intubation in morbidly obese patients.

The patients will be randomized into 4 groups:

1. S MAC: Sniffing + MAC blade.
2. R MAC: Ramped + MAC blade.
3. S D-blade: Sniffing + D-blade.
4. R D-blade: Ramped + D-blade.

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+Arms and interventions

Arm	Type	Interventions	Description
S MAC: Sniffing + MAC blade.	Active comparator	Device: Sniffing position and using MAC blade.	the patient will be positioned in sniffing position and MAC blade will be used in intubation
Ramped position and using MAC blade.	Active comparator	Device: Ramped position and MAC Blade	the patient will be positioned in Ramped position and MAC blade will be used in intubation
S D-blade: Sniffing + D-blade.	Active comparator	Device: videolaryngoscopy	the patient will be positioned in sniffing position and D-blade will be used in intubation
R D-blade: Ramped + D-blade.	Active comparator	Device: videolaryngosopy	the patient will be positioned in Ramped position and D-blade willbe used in intubation

Sniffing position and using MAC blade. (Device): Machintosch blade will be used in intubating patient in sniffing position
Ramped position and MAC Blade (Device): MAC blade will be used in intubating patient in ramped postion
videolaryngoscopy (Device): D-blade will be used in intubating patient in sniffing position
videolaryngosopy (Device): D-blade will be used in intubating patient in Ramped position

+Outcome measures

Primary outcomes

Intubation time (seconds), from blade insertion to confirmed placement via capnography. [seconds]: Intubation time (seconds), from blade insertion to confirmed placement via capnography.

+Eligibility

Sex: All, ages: 18 Years to 70 Years

Inclusion Criteria:

* Age 18-70 years.
* BMI ≥ 40 kg/m².
* ASA physical status III - IV.
* Elective surgery requiring intubation.
* Informed consent obtained.

Exclusion Criteria:

* Anticipated difficult airway unrelated to obesity.
* Cervical spine pathology.
* Pregnancy.
* Emergency surgery.
* High aspiration risk.
* OSA requiring CPAP >15 cmH₂O.
* Need for awake intubation.

+Locations (1)

Facility	City	Country	Status
Ain Shams University	Cairo, Egypt	Egypt

+Investigators

fagr fathy abdo, Medical Doctorate, Principal investigator, Ain Shams University