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Ambu®AuraGain™ Versus I-gel® in Obese Patients

Not Applicable
Completed
Conditions
Obese
Registration Number
NCT03110393
Lead Sponsor
Schulthess Klinik
Brief Summary

The aim of this study is the randomized comparison of two laryngeal mask (Intersurgical i-gel® and Ambu®AuraGain™) in obese patients

Detailed Description

Since the incidence of a difficult intubation lies between 4.5% -7.5%, the search for alternative airway devices has been forced in the past.

As an option, the laryngeal mask is suitable, which has been used as a universal airway with a high degree of safety in routine anesthesia.

There are numbers of different laryngeal masks available which have the characteristic to insert an endotracheal tube through the ventilation lumen.

The indications for these laryngeal masks can be extended due to continuous improvements in the laryngeal masks, these laryngeal masks can also be used in obese patients. Obese patients generally have a 4-fold increased risk of a difficult airway, and a BMI over 35 is a predictor of a difficult tracheal intubation.

There are no studies comparing the Intersurgical i-gel® Laryngeal Mask and the Ambu®AuraGain ™ Laryngeal Mask in obese patients.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
44
Inclusion Criteria
  • ASA 1-3
  • Shoulder-/Elbow-/Hip-/Knee- or Foot - Surgery
  • Signed informed consent
  • BMI > 35kg/m2
Exclusion Criteria
  • Non-sober patients (last meal <6 h)
  • Symptomatic reflux disease
  • Hiatus hernia
  • Significant cardiovascular risk factors
  • Severe COPD
  • Gastric band or gastric bypass
  • Disease which allows an accurate examination of the physicians (e.g. neuromuscular, mental, metabolic disease)
  • Drug or drug abuse in the recent past
  • Legal immaturity (incompetence)
  • Acute disease, which calls into question the narcotic potential
  • Patients with whom the use of a laryngeal mask is contraindicated or otherwise not possible

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Time of successful intubationintraoperative

Measurement of a fiberoptic intubation with the laryngeal mask. Start: Insertion of the fiberoptic into the larynxmask until the intubation has been done and after the fiberoptic has been removed.

Secondary Outcome Measures
NameTimeMethod
Measurement of blood pressureintraoperative

Measurement of blood pressure during 5min (1 measurement / minute).

Measurement of oxygen saturationintraoperative

Measurement oxygen saturation during 5min (1 measurement / minute).

Number of Insertions (of the laryngeal mask)intraoperative

Number of insertion attempts will be registered

Time of insertionintraoperative

The time of Insertion of the laryngeal mask will be recorded.

Number of insertion attemptsintraoperative

Number of insertions with the stomach tube will be registered

Gastric volumeintraoperative

Measurement of the gastric volume

Oropharyngeal leak pressure of the Ambu®AuraGain ™intraoperative

The oropharyngeal leak pressure of the AuraGain™ is measured with a measured cuff volume of 60cmH2O

Oropharyngeal leak pressure of the Intersurgical i-gel®intraoperative

The oropharyngeal leak pressure of the Intersurgical i-gel® is measured.

Measurement CO2 (kPa):intraoperative

The exhaled CO2 is determined continuously.

Reasons for the unsuccessful intubationintraoperative

The reasons are listed in tabular form.

Number of esophageal intubationsintraoperative

The number of esophageal intubations is measured.

Resistance (for an EET):intraoperative

The resistance is measured with a score of 1- 4. 1: simple passage, no resistance, 2: little resistance for the passage, 3: significant resistance for the passage, 4: passage not possible

Location of the mask (Brimacombe)intraoperative

The position of the mask is determined by pushing the fiber optic to a maximum of 1cm over the LMA and then using the Brimacombe score.

Swallowing (no / little / medium / strong)5hour postoperative

The swallowing difficulties are questioned preoperatively and postoperatively (5 (± 1) h after anesthesia end).

Positioning of the gastric probeintraoperative

Determination of the position of the gastric probe after successful insertion by stethoscope.

Successful Ventilationintraoperative

Detection of a successful Ventilation. There are two options: a tidal volume \> 6mL/kg lean body mass or endtidal pCO2 \< 6.7kPa

Measurement of heart rateintraoperative

Measurement of heart rate during 5min (1 measurement / minute).

Maximum ventilation pressureintraoperative

The maximum ventilation pressure is measured, which must be applied in order to adequately ventilate the patients. This is measured over 5 minutes

Number of intubation attemptsintraoperative

The number of intubation attempts until successful intubation is recorded.

Hoarseness (no / little / medium / strong)5hour postoperative

The swallowing difficulties, the throat pain and the hoarseness are questioned preoperatively and postoperatively (5 (± 1) h after anesthesia end).

Blood on laryngeal mask after intubationintraoperative

Determination of the visible blood on the laryngeal mask after removal (no, little, much).

Throat pain (no / little / medium / strong)5hour postoperative

The throat pain is questioned preoperatively and postoperatively (5 (± 1) h after anesthesia end).

Trial Locations

Locations (1)

Schulthess Klinik

🇨🇭

Zürich, Switzerland

Schulthess Klinik
🇨🇭Zürich, Switzerland
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