Operator ease and patient comfort during pre-oxygenation with high flow nasal cannula vs facemask in adult patients under general anaesthesia

Not yet recruiting

Conditions: Patients posted for elective surgery under general anaesthesia

Registration Number: CTRI/2023/08/056118

Lead Sponsor: Maulana Azad Medical College

Brief Summary: Pre-oxygennation is imperative to safety of airway management as it extends the time to hypoxemia after onset of apnea to allow adequate time for laryngoscopy ,intubation and initiation of mechanical ventilation.The safe apnea time provided by pre-oxygennation is dependant on the oxygen reservoir that is available to pulmonary circulation and can range from seconds to minutes ,depending on the patient characteristics.

Patients between age 18-60 years posted for elective surgeries under general anesthesia are included in the study.They will be divided in to two groups which are facemask and HFNC groups.After routine pre-anaesthetic evaluation,patients will be taken up to the ot. All standard ASA monitors attached and baseline parameters noted.

In Facemask group,pre-oxygennation will be done using 100% oxygen until ETO2 is >87%.Patient induced with injection Fentanyl,Propofol and Vecuronium.Bag and mask ventilation done with 100% oxygen for 3 minutes and defenitive airway will be placed.

In HFNC group,patients will be pre-oxygennated with HFNC at 40L/mt to maintain SPO2 >95% and for 3 minutres.Anaesthesia induced as facemask group and then the flow rate will be increased to 60 L/mt.Then airway will be secured.

In both groups once the airway is secured the ventilation with 100% oxygen will be continued for 5 minutes.Primary outcomes are the ease of the anaesthesiologist assessed using 10 cm visual analogue scale and patient comfort using 5 point Likert scale.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 208

Inclusion Criteria

Patients belonging to ASA physical status 1,2,3.

Exclusion Criteria

1)Patients undergoing caesarean section.
2)Any known contraindications to HFNO.
3)Patients on oxygen therapy.
4)Obese patients with BMI >35kg/m2 5)Awake intubation or with difficult airway.
6)Contraindications to CPAP.
7)Moderate to severe cardio-respiratory disease.

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
2)Patient comfort during pre-oxygennation assessed immediately before induction on a 5 point likert scale	5 minutes after securing a defenitive airway
1.Operator score during pre-oxygennation after securing the airway using 10cm visual analogue scale(VAS)	5 minutes after securing a defenitive airway

Secondary Outcome Measures

Name	Time	Method
1)Mean end tidal O2 after securing a defenitive airway & after 5 minutes.	2)Number of patients with an episode of hypoxaemia.

Trial Locations

Locations (1): Lok Nayak Hospital
🇮🇳
Central, DELHI, India
Lok Nayak Hospital
🇮🇳Central, DELHI, India
Dr Abhijith Pradeep
Principal investigator
9496252327
abhijithpradeep141@gmail.com