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Comparative Evaluation of Three Airway Maneuvers in the Unconscious Apneic Person

Not Applicable
Conditions
Airway Morbidity
Interventions
Procedure: airway maneuver
Registration Number
NCT02104453
Lead Sponsor
Tri-Service General Hospital
Brief Summary

One-handed E-C clamp mask holding technique, two-handed mask ventilation with jaw thrust, and two-handed mask ventilation with triple airway maneuver are three common airway management maneuvers. Sniffing position may improve ventilation between these three maneuvers. The investigators hypothesize that ventilation efficiency may be different between these three maneuvers whether the patient is in sniffing position or neutral position. The investigators would like to quantify this effect by measuring the expired tidal volume, airway pressure, EtCO2 slope and hemodynamic change between these three maneuvers during anesthesia induction.

Detailed Description

Mask ventilation is considered a important skill for airway management during general anesthesia induction and for apneic unconscious patients. One-handed E-C clamp mask holding technique, two-handed mask ventilation with jaw thrust, and two-handed mask ventilation with triple airway maneuver are three common airway management maneuvers. However, the efficiency of ventilation between these three maneuvers has to be clarified. Besides, whether sniffing position or neutral position may improve ventilation between these three maneuvers is to be determined. The investigators will collect airway parameters of the patients receiving general anesthesia and measure the expired tidal volume, airway pressure, EtCO2 slope and hemodynamic change between these three maneuvers during anesthesia induction.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
120
Inclusion Criteria
  • adult patients(ASA I-III) scheduled for elective surgery requiring general anesthesia with endotracheal intubation.
Exclusion Criteria
  • pneumothorax
  • SpO2<96%(without additional oxygen supply)
  • vocal cord palsy
  • congenital airway abnormality
  • facial trauma or deformity
  • acute upper airway disease
  • inadequate fasting time
  • neck or potential cervical spine disease
  • temporal-mandible joint abnormality
  • head and neck tumor
  • status post radiotherapy
  • pregnancy
  • long term sedative or opioid drug use
  • patient refuse

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
two-handed ventilation with jaw thrustairway maneuverthe airway maneuver performed with thumbs point toward feet, palms press down and other fingers perform jaw thrust
E-C clamp mask holding techniqueairway maneuverthe airway maneuver that press the mask against the patient's face (using the "C" of our thumb and forefinger) while pulling the jaw forward (using the "E" of our other fingers behind the mandible), and leaves one hand free to squeeze the bag.
triple airway maneuverairway maneuverthe airway maneuver performed with two-handed mask ventilation, jaw thrust and head-tilt chin-lift technique
Primary Outcome Measures
NameTimeMethod
Air exchangeduring anesthesia induction

Expired tidal volume, end tidal CO2 slope, peak inspiratory pressure between one-handed E-C clamp mask holding technique, two-handed mask ventilation with jaw thrust, and two-handed mask ventilation with triple airway maneuver

Secondary Outcome Measures
NameTimeMethod
Hemodynamic changeduring anesthesia induction

blood pressure and heart rate variability during ventilation between one-handed E-C clamp mask holding technique, two-handed mask ventilation with jaw thrust, and two-handed mask ventilation with triple airway maneuver

Trial Locations

Locations (1)

Tri-Service General Hospital

🇨🇳

Taipei, Taiwan

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