Anaesthetic management of otolaryngotracheal procedures using Trans Nasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE): An observational retrospective study.
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- Vital parameters Heart rate (HR), blood pressure (BP), SpO2, respiratory rate (RR), end tidal carbon dioxide (ETCO2) noted in the preoperative, intraoperative and postoperative period.
研究概览
简要总结
Anaesthesia for shared airway surgeries pose special challenge due to shared airway by anaesthesiologist and surgeons. Special anaesthesia techniques have been used for maintaining oxygenation & ventilation during these otolaryngotracheal surgeries. Apnoeic anaesthesia which is needed in these surgeries can be provided with various techniques and THRIVE is a recent addition to it. [1,2]
Trans Nasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) has unique applications for use during anaesthesia. THRIVE is a technique that allows delivery of upto70 litres of oxygen per minute at 37degree Celsius, with absolute humidity of 44mg H2O/L and an FiO2 up to 1. Anaesthesia for airway surgeries need special techniques owing to shared airway and higher risk of airway complications. A tubeless surgical field in a shared airway is always the preferred technique & long apnea is possible due to THRIVE maintaining oxygenation & ventilation. THRIVE avoids the need for intubation in airway surgeries and associated complications.
However being novel technique there are limited studies available and no studies published on Indian population. Hence, we decided to conduct an observational retrospective study on anaesthetic management of patients in ENT OT for various surgical procedures in which THRIVE was used.
AIM
Anaesthetic management of otolaryngotracheal procedures using Trans Nasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE)
**OBJECTIVES: To study the following parameters-**Vital parameters, SPO2, ETCO2, ABG parameters, Duration of THRIVE use, Flow used, Peri-operative course, Surgical procedure and duration, Complication if any and management
References.
1. Pearson KL, McGuire BE. Anaesthesia for laryngo-tracheal surgery, including tubeless field techniques. BJA Educ. 2017;17:242–8. 2. Jaquet Y, Monnier P, Van Melle G, Ravussin P, Spahn DR, Chollet-Rivier M. Complications of different ventilation strategies in endoscopic laryngeal surgery: a 10-year review. Anesthesiology. 2006 Jan;104(1):52-9. doi: 10.1097/00000542-200601000-00010. PMID: 16394690.
3. Patel A. Nouraei SA. Transnasal Humidified Rapid-Insufflation Ventilatory Exchange(THRIVE): a physiological method of increasing apnoea time in patients with difficult airways. Anaesthesia 2015;70:323-9
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 2.00 Year(s) 至 80.00 Year(s)（—）
- 性别
- All
入选标准
- •All the patients who underwent otolaryngotracheal surgical procedures under anaesthesia with use of THRIVE during the study period.
排除标准
- •All the patients who underwent otolaryngotracheal surgical procedures under anaesthesia without THRIVE during the study period.
结局指标
主要结局
Vital parameters Heart rate (HR), blood pressure (BP), SpO2, respiratory rate (RR), end tidal carbon dioxide (ETCO2) noted in the preoperative, intraoperative and postoperative period.
时间窗: Intra-operative and postoperative
THRIVE Flow used
时间窗: Intra-operative and postoperative
Intra-operative and postoperative course
时间窗: Intra-operative and postoperative
次要结局
- Intra-operative and postoperative desaturation or hypercarbia, need for intubation(Intra-operative and postoperative)
研究者
Dr Minal Harde
Topiwala National Medical College