Comparative Evaluation of One-handed E-C Clamp Mask Holding Technique, Two-handed Mask Ventilation With Jaw Thrust, and Two-handed Mask Ventilation With Triple Airway Maneuver in the Unconscious Apneic Person
Trial Snapshot
- Phase
- Not Applicable
- Sponsor
- Tri-Service General Hospital
- Enrollment
- 120
- Locations
- 1
- Primary Endpoint
- Air exchange
Study Overview
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.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Crossover
- Primary Purpose
- Treatment
- Masking
- Single (Participant)
Eligibility Criteria
- Ages
- 20 Years to 80 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
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
Arms & Interventions
E-C clamp mask holding technique
the 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.
Intervention: airway maneuver (Procedure)
two-handed ventilation with jaw thrust
the airway maneuver performed with thumbs point toward feet, palms press down and other fingers perform jaw thrust
Intervention: airway maneuver (Procedure)
triple airway maneuver
the airway maneuver performed with two-handed mask ventilation, jaw thrust and head-tilt chin-lift technique
Intervention: airway maneuver (Procedure)
Outcomes
Primary Outcomes
Air exchange
Time Frame: during 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 Outcomes
- Hemodynamic change(during anesthesia induction)
Investigators
Wei-Hung Chan
Anesthesiology Department, Tri-Service General Hospital
Tri-Service General Hospital