Pre Oxygenation with cushioned tight fitting face mask in 20 degrees head up position versus High flow nasal oxygen in supine position in elective surgeries -A Prospective,Randomised,Controlled Study.
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- To record the time to desaturate to 92% from the onset of apnoea.
研究概览
简要总结
Endotracheal Intubation requires an anaesthetic induction process which results in loss of consciousness and neuromuscular block which causes hypoventilation and apnoea. This carries a risk of hypoxia which is further exacerbated in difficult endotracheal intubation. Routine practice of preoxygenation before induction of anaesthesia is recommended as a delay in oxygenation may not be anticipated.
The goal of preoxygenation with 100% oxygen before induction is to extend time to desaturation by replacing nitrogen with oxygen and increase oxygen stores. Preoxygenation increases total body oxygen stores from 1.2 litres(L) before oxygenation to 3.2 L at 1minute and 4.8 L at 3 minutes.
Oxygen is commonly delivered by a cushioned face mask at 15 L/min. An alternative method is delivery of humidified oxygen via High flow nasal cannula (HFNC)(inspiredTMO2FLO,Vincent Medical Manufacturing Co.Ltd ,Hong kong.) . High flow nasal cannula is a oxygenation device which can deliver upto 60L/min of humidified and heated gas with 100% Fraction of inspired oxygen(Fio2).
The efficacy of preoxygenation is improved by placing the patient in 45 degrees head up position as compared to supine ,but repositioning of patient is needed to avoid exacerbation of arterial hypotension and to allow securing airway. This manoeuvre may also facilitate passive regurgitation of gastric contents and pulmonary aspiration . We adopted the 20 degrees head up position during preoxygenation and induction which was initially proposed by S. Lane et al. This position allows for improved oxygenation and intubation without alteration in position.
In this study , we aim to compare two different methods of preoxygenation .We theorised that preoxygenating patient with face mask(Group M) in 20 degrees position of patient during induction will prolong the apnoea time significantly than in patients preoxygenated with HFNC (Group N) in supine position.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 盲法
- None
入排标准
- 年龄范围
- 18.00 Year(s) 至 65.00 Year(s)（—）
- 性别
- All
入选标准
- •1.American society of anaesthesiologists physical status(ASA) I,II 2.Patients of age 18to 65 years.
- •Body mass index (BMI) less than 30kg/m
- •4.Patients undergoing Elective surgeries under general anaesthesia.
排除标准
- •1.Patient refusal to give consent.
- •2.Pregnant women.
- •3.Patient having Nasal obstruction.
- •4.Baseline oxygen saturation less than 96% while breathing on room air in sitting position .
- •5.Anticipated Difficult Airway Mallampati grade [MPG]greater or equal to 3 6.Previous allergy to drugs used in standard anaesthetic regimen.
结局指标
主要结局
To record the time to desaturate to 92% from the onset of apnoea.
时间窗: Time taken by patient from point of visual confirmation of apnoea (T0) to point of desaturation to 92% (T1)
次要结局
- 1.To record lowest Saturation of peripheral oxygen (SPO2) during first five breaths immediately post procedure.(2.To record Highest End Tidal Carbondioxide (ETCO2) during first five breaths immediately post procedure.)
研究者
Dr M Suryakumar Rupika
Sri Venkateswara Institute of Medical Sciences