A Comparison of Laryngeal Mask UniqueTM in Denticulate and Edentulate Geriatric Patients
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 66
- 试验地点
- 2
- 主要终点
- Number of Participants With Successful Laryngeal Mask Placement
研究概览
简要总结
As a result of rises in living standards quality of life is progressively increasing. Combined with developments in anesthesia, surgical techniques and medication allowing more difficult and complicated interventions to be carried out, elderly patients are encountered more often in daily anesthetic practice.Reduced tone in the upper airway of geriatric patients increases the possibility of airway obstruction. In old patients with no teeth, sunken cheeks may make ventilation with a mask ineffective; perhaps even impossible.
In addition to our observations that Laryngeal mask (LM) is more difficult to place in older patients, in the literature there are very few studies on the use of LM in older patients. Sixty percent of patients over the age of 65 have no teeth. Ventilation with a mask is more difficult for patients without teeth compared to those with teeth. Laryngeal mask is an alternative airway device for patients without teeth when the face mask does not sit correctly.
The aim of this study is primarily to measure the success of placement on first try, ease and duration of insertion and oropharyngeal leak pressure of laryngeal mask Unique (LMU) in patients 65 years of age and above dentulous and edentulous elderly patients. The secondary aim is to compare the effects on the hemodynamic response occurring during placement.
详细描述
This study received permission from Dokuz Eylül University Medical Faculty Ethics Committee and informed consent was obtained from the patients. Sixty-six patients above the age of 65 with American Society of Anesthesiologists (ASA) physiological classification group I-III, undergoing elective surgery and with indications for laryngeal mask placement participated in this prospective, and double bland study.
Patients taken to the operating room were monitored for heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP), electrocardiography (ECG-Derivation II), and peripheral oxygen saturation (SpO2) before anesthesia induction. Depth of anesthesia was evaluated with a bispectral index monitor. The patients were preoxygenated with 6 L.min-1 oxygen through a face mask for 3 minutes. For anesthesia induction 0.02 mg.kg-1 midazolam, 1-2 μg.kg-1 fentanyl and 1-2 mg.kg-1 propofol were used. Afterwards patients were given mask ventilation with 100% oxygen. Before laryngeal masks were inserted they were prepared by being lubricated with water-based gel and the cuffs were completely deflated.
After induction agents were administered when BIS values were between 40-60 and sufficient chin relaxation was obtained LMU was inserted according to the standard methods determined by Brain. The LMU size was chosen based on the patient's body weight; those from 30-50 kg used no. 3, from 50-70 kg used no. 4 and those from 70-100 kg used no 5 LMU. During attempts depending on the patient reaction and to keep the BIS values 40-60, an additional dose of 0.5 mg/kg propofol was administered.
The cuffs of the laryngeal mask were inflated and held at 60 centimeters of water. After the operation before the LM was removed the cuff inner pressure was measured again and recorded. The success of the first attempt at insertion of the laryngeal mask was recorded. During placement in cases with 3 unsuccessful attempts, patients were intubated to provide airway management.
Anesthesia was maintained with a 50% O2/air mix with 1.5-2.5% sevoflurane. Concentration of sevoflurane was set to keep the bispectral index value below 40.
研究设计
- 研究类型
- Interventional
- 分配方式
- Non 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
- 65 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Above the age of 65
- •ASA I-III
- •Undergoing elective surgery
排除标准
- •Patients with recent history of upper respiratory infection
- •Obese patients with body-mass index above 35 kg/m2
- •Symptomatic hiatus hernia
- •Severe gastroesophageal reflux
- •Those with low pulmonary compliance or high airway resistance (morbid obesity, lung disease)
- •Throat pain, dysphagia and dysphonia
结局指标
主要结局
Number of Participants With Successful Laryngeal Mask Placement
时间窗: Baseline
The aim of this study is primarily to measure the success of placement on first try in dentulous and edentulous elderly patients for success of placement on first try.
次要结局
- Oropharyngeal Leak Pressure(Baseline)
- Ease of Placement Laryngeal Mask(During Laryngeal mask placement)
- Haemodynamic Response to Insertion of Airway Device.(Before anesthesia induction, before laryngeal mask insertion and in the 1st, 2nd, 3rd and 5th minutes after laryngeal mask insertion)
- Insertion Time of Laryngeal Mask(During placement of Laryngeal Mask)
研究者
Sule Ozbilgin
Anaesthesiology and Reanimation
Dokuz Eylul University