The Predictor of Respiratory Discomfort After the Shoulder Arthroscopic Surgery
- Conditions
- Shoulder Arthroscopic Surgery
- Interventions
- Other: upper airway ultrasonographic examination
- Registration Number
- NCT01401205
- Lead Sponsor
- Samsung Medical Center
- Brief Summary
The investigators applied upper airway ultrasonographic examination focusing the measurement of upper airway diameters in patients undergoing shoulder arthroscopic surgery to evaluate the change of upper airway anatomy before and after the surgery. The investigators also tried to find any findings of ultrasonographic examination that could reliably predict the dyspnea or airway compression after extubation. The investigators tried to compare the ultrasonographic findings with those of chest radiograph to validate the measurements of the ultrasonographic examination. A cuff leak test was preformed to evaluate its ability to predict the upper airway obstruction in shoulder arthroscopic surgery.
- Detailed Description
During shoulder arthroscopic surgery, extravasation of irrigation fluid can occur around the shoulder and trachea, compressing the upper airway. Although the extravasation is generally reabsorbed asymptomatically within 12 hours, there are cases that lead to reintubation or life-threatening complications.
An endotracheal tube is the most reliable method of securing the airway from airway obstruction during a shoulder arthroscopy surgery. However, since the airway may become obstructed after extubation, airway patency should be verified before extubation. Direct visualization of the larynx or trachea using laryngoscopy or bronchoscopy is difficult due to the presence of the tracheal tube. A cuff leak around the tracheal tube in a cuff-deflated condition is suggested to be a predictor of successful extubation. However, its reliability has been questioned in adult patients. A cuff leak could be affected by paratracheal pressure, which is thought to be elevated during shoulder arthroscopy. In a recent study, it was shown that laryngeal ultrasound can be a reliable, non-invasive method for the evaluation of laryngeal morphology or predicting post-extubation stridor.
The investigators applied upper airway ultrasonographic examination focusing the measurement of upper airway diameters in patients undergoing shoulder arthroscopic surgery to evaluate the change of upper airway anatomy before and after the surgery. The investigators also tried to find any findings of ultrasonographic examination that could reliably predict the dyspnea or airway compression after extubation. The investigators tried to compare the ultrasonographic findings with those of chest radiograph to validate the measurements of the ultrasonographic examination. A cuff leak test was preformed to evaluate its ability to predict the upper airway obstruction in shoulder arthroscopic surgery.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 100
- patients undergoing elective shoulder arthroscopic surgery (rotator cuff repair)
- patients with airway anomaly
- patients with anticipated difficult airway
- patients with hemodynamic unstability
- patients with severe cardiopulmonary disease
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description shoulder arthroscopic surgery group upper airway ultrasonographic examination the patients who undergo the elective shoulder arthroscopic surgery of rotator cuff repair
- Primary Outcome Measures
Name Time Method Airway transverse diameter 20 min after end of surgery airway transverses diameter measured on the upper airway ultrasonographic image: measure at three level (vocal cord, subglottis, trachea)
- Secondary Outcome Measures
Name Time Method depth of skin to airway anterior border 10 min before anesthesia induction and 20 min after the surgery depth of skin to airway anterior border measured at three levels: vocal cord, subglottis, trachea level
depth of skin to pleura 10 min before anesthesia induction and 20 min after the end of surgery bilateral depth of skin to pleura at first and third intercostal space on the midclavicualr line measuread on the ultrasonographic image
endotracheal tube balloon cuff pressure 10 min after anesthesia induction and 60 min after surgery start endotracheal tube balloon cuff pressure
percent cuff leak 10 min after anesthesia induction and 60 min after surgery start The difference in the actual exhaled volume between the averages of pre- and post-cuff deflation was calculated. This number was divided by the tidal volume before cuff deflation and multiplied by 100. The resulting number was recorded as the percent cuff leak.
Trial Locations
- Locations (1)
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of