Health Condition 1: O- Medical and Surgical
Conditions
Interventions
Intervention1: Remifentanil Propofol Ketamine with Spontaneous Breathing: Induction
Propofol bolus 1 to 1.5 mg per kg IV
Fentanyl 1 to 2 g per kg
When feasible a transtracheal block with 10cc of In
patient kept in spontaneous ventilation with assisted ventilation only if necessary such as transient hypoventilation.
Oxygen via rigid bronchoscope side port at 10l per min
Control Intervention1: S
Sponsors
Sri shankara cancer hospital and research centre
Eligibility
Inclusion criteria
Inclusion criteria: Scheduled for elective or urgent that are not an emergency either gender to be included rigid bronchoscopy involving central airway obstruction and tracheoesophageal fistula procedures will be grossly divided into 2 subsets during data analysis as simple procedures that require less than or upto 1 hour and complex procedures that may last more than 1 hour ASA physical status I III
Exclusion criteria
Exclusion criteria: Patient refusal Emergency procedures requiring immediate airway control Known allergy or contraindication to remifentanil, propofol, ketamine, or neuromuscular blockers used in the protocol Severe uncontrolled cardiovascular disease (e.g. unstable angina, decompensated heart failure, severe valvular disease) Raised intracranial pressure Cervical spine instability Significant psychiatric disease precluding ketamine use (e.g. active psychosis)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Composite respiratory score, hemodynamics, respiratory acidosis, surgeons satisfaction scoreTimepoint: ONCE DURING SURGERY CONTINUOSLY FOR HEMODYNAMICS | — |
Secondary
| Measure | Time frame |
|---|---|
| Patients VAS score for pain at the end of the procedure,adverse effects and nausea and vomitingTimepoint: Once at the end of the procedure | — |
Countries
India
Contacts
Public ContactJANAKI PADMAKUMAR
SRI SHANKARA CANCER HOSPITAL AND RESEARCH CENTRE
Outcome results
None listed