A clinical study to see the effect of different ventilator settings on blood oxygen levels under general anesthesia

Not yet recruiting

Conditions: Medical and Surgical,

Registration Number: CTRI/2020/03/023887

Lead Sponsor: Department of Anaesthesiology and Intensive Care

Brief Summary: Endotracheal intubation or bag-and-mask ventilation have been the mainstays of airway management for several decades. In 1983, this changed with the invention of the laryngeal mask airway (LMA) which provided ease of placement and hands-free maintenance along with a relatively secure airway. LMA is increasingly being used in all patient population including children and has been found to be very safe and efficacious in various studies.

In the paediatric age group, the outward recoil of the chest wall is low, but the inward lung recoil is similar to that of a young adult. As the Functional Residual Capacity (FRC) is the lung volume at which the outward recoil of the chest wall exactly balances that of the inward recoil of the lungs, this leads to a reduced FRC in children. In awake state, the FRC is maintained by mechanisms such as active diaphragmatic and intercostal expiratory tone, but under general anaesthesia the closing volume tends to increase and the functional residual capacity decreases resulting in atelectasis and subsequent decreased arterial oxygenation.

The application of adequate tidal volumes and a positive end-expiratory pressure (PEEP) play an important role in counteracting this airway closure and atelectasis in paediatric patients under general anaesthesia. This is usually achieved by using an endotracheal tube. However the ProSeal LMA (PLMA) has been shown to form a more effective seal than the Classic LMA and can be used to deliver PEEP which may improve gas exchange in children.5.6

There are few studies evaluating the use of PEEP with a supraglottic airway device in the paediatric age group in an attempt to minimise small airway closure. Hence we thought it worthwhile to compare the use of PLMA for pressure controlled ventilation with and without PEEP for improving oxygenation in paediatric patients.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 30

Inclusion Criteria

1.American society of anesthesiologist (ASA) physical status I 2.Patients undergoing surgical procedures permitting the use of supraglottic devices.

Exclusion Criteria

1.Any upper or lower respiratory infections, asthma, cystic fibrosis etc.
2.Patient at risk of aspiration.
3.Patient with anticipated difficult airway.
4.Patients with reduced lung compliance, obesity or those with musculoskeletal disorders.
5.Patient undergoing spine and thoracoabdominal surgeries.
6.Patients requiring surgeries in prone or lateral positions.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Partial pressure of O2 (PaO2)	30 mins after the institution of positive end expiratory pressure

Secondary Outcome Measures

Name	Time	Method
Partial pressure of CO2 (PaCO2)	30 mins after the institution of positive end expiratory pressure
Any co-relation between the fibre optic grading and the Partial pressure of O2 (PaO2) levels	30 mins after the institution of positive end expiratory pressure
Arterial blood pH	30 mins after the institution of positive end expiratory pressure
Oropharyngeal seal pressure	After successful placement of the Proseal LMA.

Trial Locations

Locations (1): Lok Nayak Hospital
🇮🇳
Central, DELHI, India
Lok Nayak Hospital
🇮🇳Central, DELHI, India
Arpit Singh
Principal investigator
9911962715
hobbygator@gmail.com