Lung Diseases, Total Intravenous Anesthesia, Tracheal Diseases
Conditions
Brief summary
THRIVE and iGEL were applied for maintain oxygenation in bronchoscopic interventions which could not performed with an endotracheal tube. However, besides the risk of desaturation, the differences on difficulties to approach vocal cords, the responses to spay of local anesthetics including cough or spasm, the CO2 elimination, the hemodynamic changes, and the effects on postoperative recovery are rarely investigated.
Detailed description
THRIVE and iGEL were applied for maintain oxygenation in bronchoscopic interventions which could not performed with an endotracheal tube. Unlike the nasal cannula with THRIVE, the tips of iGel are located in upper esophagi, it may affect the postoperative swallowing, especially for the aged group. However, the bronchoscopic approach may be easier for an established route to vocal cords. With shared airway for ventilation and interventions, CO2 elimination is hardly monitored besides the risk of desaturation. In this study, THRIVE or iGel was planned to be randomized used for bronchoscopic interventions in an adult group (age 20-65) and an aged group (age over 65). The difficulties to approach vocal cords, the responses to spay of local anesthetics including cough or spasm, the CO2 elimination, the hemodynamic changes, and the effects on postoperative recovery are compared between THRIVE and iGel groups.
Interventions
PROCEDUREThe responses to bronchoscopic insertion for bronchoscopic interventions such asTBNA, Cryotherapy, etc.
cough response, the changes of BP, HR, SpO2, Trans dermal CO2 during bronchoscopic interventions
PROCEDUREpostoperative recovery
anesthetic recovery in postoperative care unit recovery of swallowing by questionnaire in POD1
Sponsors
National Taiwan University Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* plan to receive bronchoscopic interventions with total intravenous anesthesia
Exclusion criteria
* awake bronchoscopy pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| response to spraying local anesthetics by bronchoscopy | from visualizng vocal cords to complete local anesthetic spray in trachea and main bronchi | the status of vocal cords visualized (relaxed, closed, relaxed but close with spray of local anesthetics); cough scale during bronchoscopic insertion and spray of local anesthetics |
| difficulty of bronchoscopic approach | from bronchoscopic insertion to visualize vocal cords | time from insertion to visualize vocal cord, records of manipulations if applied |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| cough scale | from bronchoscopic insertion to the end of procedure | cough intensity X times |
| SPO2 | every 5 minutes from bronchoscopic insertion to the end of procedure | pulse oximeter, hemoglobin saturation (%) |
| postanesthetic recovery | from admission to PACU to discharge from PACU | time stay in postoperative care unit (minutes) |
| Transdermal CO2 | every 5 minutes from bronchoscopic insertion to the end of procedure | data obyenied from transdermal CO2 (mmHg) |
| hemodynamic changes | from bronchoscopic insertion to 20 minutes after completion of local anesthetic spraying | changes on MAP (mmHg) |
Other
| Measure | Time frame | Description |
|---|---|---|
| EAT-10 questionnaire (score):0-40 | preoperative and postoperative day 1 | EAT-10 for postbronchoscopic swallowing dysfunction, from 0 (normal swallowing) to 40 (extreme difficulty on swallowing) |
Countries
Taiwan
Outcome results
None listed