Anesthesia Induction, Apneic Oxygenation, Bariatric Surgery, High-flow Nasal Cannulae
Conditions
Brief summary
Before going off to sleep patients are given oxygen to saturate blood with oxygen to extend time before a decrease in the level of oxygen in the blood occurs. During this period, obese patients have a faster decrease in the level of oxygen in their blood. This study uses a device called high-flow nasal cannula (HFNC), which delivers humidified high-flow oxygen through 2 small plastic tubes placed just inside nostrils. In the intensive care unit settings this device has been used extensively and has become a standard practice. Purpose of this study is to determine whether these high-flow nasal cannula increase the time safely when going to sleep during elective surgery.
Interventions
DEVICEHFNC
High flow nasal oxygen (60 l) under GA
DEVICECON (control)
Standard oxygen (10-15 l) under GA
Sponsors
University Health Network, Toronto
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Intervention model description
Consented patients will be randomly assigned either to the interventional group (High Flow Nasal Cannula- HFNC) or to the control group (CON). The Group HFNC will be preoxygenated using HFNC and the Group CON will receive standard preoxygenation.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age more than18 years old * ASA status I-III * Elective surgery performed under general anesthesia requiring endotracheal intubation * BMI more than 40 kg/m2
Exclusion criteria
* Chronic respiratory disease * SpO2 \<98% after supplementing oxygen * Previous or anticipated difficult intubation * Uncontrolled hypertension * Ischemic heart disease * Congestive heart failure * Increased intracranial pressure * Uncontrolled GERD * Known allergy or contraindication to anesthesia drugs * Nasal blockade contraindicating the use of HFNC
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Measurement of safe apnea time | Maximum up to 6 minutes | Safe apnea time, defined by time to desaturation (SpO2 \> 95%) or apnea maximum up to 6 minutes |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Highest EtCO2 | Every minute up to 5 minutes on commencing ventilation | Highest EtCO2 on commencing ventilation |
| Lowest SpO2 | Every minute up to 5 minutes after intubation | Lowest SpO2 during intubation procedure |
| Time to regain baseline SpO2 | Up to 5 minutes after intubation | Time to regain baseline SpO2 after intubation |
Countries
Canada
Outcome results
None listed