The Influence of Head and Neck Position On The Oropharyngeal Leak Pressure of LMA Unique ™ and I-GEL™
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 103
- 试验地点
- 2
- 主要终点
- Oropharyngeal Leak Pressure
研究概览
简要总结
Airway management is one of the basic topics in anesthetic practice. Use of endotracheal intubation and face mask are standard methods to maintain an open airway widely adopted for many years. As a result of a search for more appropriate choices from the point of view of effectiveness, reliability and side effects, supraglottic airway devices (SGAD) have been developed.
SGAD's are used for thyroid surgery, ear surgery, carotid endarterectomy, adenotonsillectomy and laser pharyngoplasty, which require a variety of head-neck positions. Changing the head and neck position leads to changes in the shape of the pharynx, which causes variation in the cuff pressure and oropharyngeal leak pressure. Oropharyngeal leak pressure values play a determining role in protecting the airway from high cuff pressure. Additionally it shows that the laryngeal mask is correctly placed and is a sign of the effectiveness of positive pressure ventilation. During surgery head-neck and trunk position may change. As a result there is a need for research evaluating the effect of head and neck position on oropharyngeal leak pressure during SGAD use.
AIM
The aim of this study is to compare the effect of different head and neck positions on the oropharyngeal leak pressure in LMA-Unique and I-Gel applications. Additionally the placement duration, ease and success of these two supraglottic airway devices will be compared.
详细描述
This prospective, randomized, double-blind study will receive permission from the Local Research Ethics Committee and after obtaining patients' informed consent, 103 patients with American society of anesthesiologists (ASA) classification group I-II, between 18-65 years, undergoing elective surgery with indications for supraglottic airway device placement were included in the study.
All patients preoperatively evaluated and ASA and Mallampati classification recorded.
All SGAD's inserted by the same experienced researcher. After placement of laryngeal mask, to standardize postoperative pharyngeal morbidity, cuff pressure (cuff pressure manometer, Ruch, Germany) was monitored.
EXCLUSION CRITERIA:
- Any neck or upper respiratory pathology
- Those at risk of gastric content regurgitation/aspiration (previous upper Gastro-intestinal surgery, known hiatus hernia, Gastroesophageal reflux, history of peptic ulcer, full stomach, pregnancy)
- Possibility of and those with history of difficult intubation (history of impossible intubation, Mallampati classification 3-4, sterno mental distance less than 12 cm, thyromental distance less than 6 cm, head extension less than 90 degrees, mouth opening less than 1.5 cm)
- Those with low pulmonary compliance or high airway resistance (morbid obesity, lung disease)
- Throat pain, dysphagia and dysphonia
- Patients with cervical disc hernia
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Screening
- 盲法
- Double (Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •18-65 years
排除标准
- •Any neck or upper respiratory pathology
- •Those at risk of gastric content regurgitation/aspiration (previous upper gastro-intestina system surgery, known hiatus hernia, gastroesophageal reflux, history of peptic ulcer, full stomach, pregnancy)
- •Possibility of and those with history of difficult intubation (history of impossible intubation, Mallampati classification 3-4, sterno mental distance less than 12 cm, thyromental distance less than 6 cm, head extension less than 90 degrees, mouth opening less than 1.5 cm)
- •Those with low pulmonary compliance or high airway resistance (morbid obesity, lung disease)
- •Throat pain, dysphagia and dysphonia
- •Patients with cervical disc hernia
研究组 & 干预措施
Group U (UNIQUE)
Group LMA- UNIQUE, inserted according to described standard method. Between 30-40 kg, no.3. Between 50-70 kg, no. 4 Between 70-100 kg, no. 5. LMA-Unique Before SGAD is inserted, a water-based lubricant without local anesthetic, was spread on the surfaces that will touch the palate and LMA-U cuff was completely deflated.oup U (UNIQUE): Group Laryngeal Mask Airway-Unique.
干预措施: Group U (UNIQUE) (Device)
Group I (I-GEL ): Group I-GEL
Group I (I-GEL): Between 30-60 kg, no. 3. Between 50-90 kg, no. 4. For > 90 kg no.5. I-GEL
干预措施: I-GEL (Device)
结局指标
主要结局
Oropharyngeal Leak Pressure
时间窗: Immediately after head and neck positioning is completed
The aim of this study is to compare the effect of different head and neck positions on the oropharyngeal leak pressure in LMA-Unique and I-Gel applications. Head and neck positions are limited to neutral, extension and right laterally deviated.
次要结局
- The Time for Successful Placement (Second)(Baseline to first successful ventilation, in seconds)
- Number of Attempts(Baseline to first successful ventilation,)
- Ease of Placement(Baseline)
- Incidence of Post-operative Sore Throat(at postoperative 1st and 24th hours)
研究者
Sule Ozbilgin
Anaesthesiology and Reanimation
Dokuz Eylul University