Airway Ultrasound as a Predictor for Postextubation Stridor in Cervical Spine Surgery [Anterior Approach]: Prospective Observational Study
试验速览
- 阶段
- 不适用
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- the correlation between the post procedural laryngeal air-column width difference [LACWD] as obtained by laryngeal US with occurrence of postextubation stridor
研究概览
简要总结
literature on use of the ultrasound (US) in extubation decisions in cervical spine surgery is scarce.The aim of this study will be to evaluate the utility of US as an aid for decision making for extubation in elective cervical spine surgery (anterior approach) operations and as a predictor for postextubation stridor in these operations
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •surgeries associated with either exposure of more than three vertebral bodies,
- •exposures involving the C2-C4 levels,
- •blood loss exceeding 300 mL
- •surgical time of more than five hours,
排除标准
- •laryngotracheobronchial pathology,
- •severe cardiorespiratory disease,
- •admitted for redo-surgery
- •intubated prior to operation
- •Patient with anesthetic risk factors include Mallampati 3 or 4 and multiple intubation attempts
结局指标
主要结局
the correlation between the post procedural laryngeal air-column width difference [LACWD] as obtained by laryngeal US with occurrence of postextubation stridor
时间窗: First 6 hours postoperatively
At the end of operation, laryngeal air column width \[which is defined as the width of air between the vocal cords as demonstrated by US\] will be obtained while the tube cuff is inflated then while it is deflated for three consecutive respiratory cycles after gentle suction of oropharyngeal airway. The laryngeal air-column width difference \[LACWD\] (the difference between width at balloon-cuff deflation and at balloon-cuff inflation) will be obtained and the average value will be recorded. Patient will be considered ready for extubation after performance of the cuff-leak test as \[the volume of reduced cuff leak test is more than 110 ml\] then reversal of neuromuscular blockade will be done. They tube will be removed when the patients can open their eyes on verbal commands and the T4/T1 ratio is 90% or more. After transferal of patients ICU where they will be observed for occurrence of postextubation stridor in the first 6 hour postoperatively.
次要结局
- Incidence of other airway complication as hematoma(Intraoperative pre-extubation)
研究者
Marwa Ahmed Khairy Elbeialy
Lecturer of Anesthesia
Ain Shams University