covalent is a three-arm, randomized-controlled multi center trial. covalent tests the hypothesis that video-assisted laryngoscopy for endotracheal intubation in surgical procedures is non-inferior to conventional direct laryngoscopy.
This trial is supported by the German Society for Anesthesiology and Intensive Care.
![](https://covalent-trial.org/wp-content/uploads/2022/06/DGAI_Logo_homepage-1024x292.png)
After informed consent, patients will be randomized into one of three arms. Within each arm, one type of laryngoscope will be used primarily: conventional laryngoscope with a Macintosh-shaped blade, video-assisted laryngoscope with a Macintosh-shaped blade and video-assisted laryngoscope with a hyperangulated blade, respectively. Additionally, interactions between team members (anesthetist and anesthesia nurse)
inclusion criteria
- adult patients capable of informed consent
- elective, non-cardiac surgery under general anesthesia requiring endotracheal intubation
exclusion criteria
- pregnancy
- past enrolment in the trial
- need for fiberoptic (endoscopic) intubation
- bariatric surgery
- urgent medical concerns voiced by the responsible treating anesthetist
interventions
![](https://covalent-trial.org/wp-content/uploads/2022/06/CL-M-902x1024.jpg)
![](https://covalent-trial.org/wp-content/uploads/2022/06/VL-M-902x1024.jpg)
![](https://covalent-trial.org/wp-content/uploads/2022/06/VL-H-902x1024.jpg)
endpoints (selection)
- first-attempt success (dichotomous, primary endpoint)
- time to successful intubation
- time to glottis view
- Cormack & Lehane grade
- number of attempts
- drop of peripheral oxygen saturation (SpO2) below 90%
- dental damage
- Mayo High Performance Teamwork Scale and NASA taskload index (care providers)
- coughing or sore throat