General Anesthesia
Conditions
Brief summary
The influence of different head and neck positions on the effectiveness of ventilation with the Ambu AuraGain airway remains unevaluated. This study aimed to evaluate the influence of different head and neck positions on ventilation with the AuraGain airway. AuraGain will be placed in all patients, and mechanical ventilation will be performed using a volume-controlled mode with a tidal volume of 10 ml/kg. The expiratory tidal volume, peak inspiratory pressure, oropharyngeal leak pressure, and ventilation score will be assessed first for the neutral head position and then for the extended, flexed, and rotated head positions in a random order. Fiberoptic bronchoscopic view will be also assessed for each head and neck positions.
Interventions
PROCEDUREFlexion
After changing the position of head and neck of subjects to flexion, the variables were measured.
PROCEDUREExtension
After changing the position of head and neck of subjects to extension, the variables were measured.
PROCEDURERight rotation
After changing the position of head and neck of subjects to right flexion, the variables were measured.
Sponsors
Seoul National University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
OTHER
Masking
SINGLE (Subject)
Intervention model description
AuraGain will be placed in all patients, and mechanical ventilation will be performed using a volume-controlled mode with a tidal volume of 10 ml/kg. The expiratory tidal volume, peak inspiratory pressure, oropharyngeal leak pressure, and ventilation score will be assessed first for the neutral head position and then for the extended, flexed, and rotated head positions in a random order. Fiberoptic bronchoscopic view will be also assessed for each head and neck positions.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults who were to undergo elective surgery under general anaesthesia using supraglottic airway device
Exclusion criteria
* Patients who had risk factor for difficult intubation * BMI \> 30kg/m2 * Emergency operation without NPO * History of cervical spine surgery or disease * History of esophageal operation or gastroesophageal reflux disease
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Oropharyngeal leak pressure | 30 seconds after positioning of head and neck | The airway pressure at which a leak sound is detected around the patient's mouth and at which the airway pressure has reached equilibrium, when the pressure-limiting valve of the anesthesia breathing system is closed and the fresh gas flow rate was fixed at 3 L/min. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Peak inspiratory pressure | 30 seconds after positioning of head and neck | Peak inspiratory pressure |
| Expiratory tidal volume | 30 seconds after positioning of head and neck | Expiratory tidal volume |
| Ventilation score | 30 seconds after positioning of head and neck | No leakage with an airway pressure of 15cmH2O; bilateral chest excursion with a peak inspiratory pressure of 20cmH2O; and a square-wave capnogram |
| Fiberoptic score | 30 seconds after positioning of head and neck | 1, vocal cords not visible; 2, vocal cords plus anterior epiglottis visible; 3, vocal cords plus posterior epiglottis visible; 4, only vocal cords visible |
Countries
South Korea
Outcome results
None listed