Induction of General Anesthesia
Conditions
Keywords
High flow nasal oxygenation, Facemask ventilation, Gastric insufflation
Brief summary
This is a randomized controlled study to compare the incidence of gastric insufflation when using high-flow nasal oxygenation and facemask ventilation in pediatric patients.
Interventions
DEVICEHFNO group
100% oxygen supplied in proportion to body weight using the Optiflow THRIVETM system while maintaining jaw thrust. (0-12 kg; 2 L/kg/min, 13-15 kg; 30 L/min, 16-30 kg; 35 L/min, 31-50 kg; 40 L/min)
DEVICEMV group
Mask ventilation using the one-hand E-C clamp technique and oropharyngeal airway (fresh gas flow 3 l/min, 100% O2, tidal volume 8-10 ml/kg, respiratory rate 20/min, I:E ratio 1:2, pop-off valve 13 cmH2O).
Sponsors
Ajou University School of Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
1 Years to 6 Years
Healthy volunteers
No
Inclusion criteria
* Pediatric patients aged 1 to 6 years * American Society of Anesthesiologists physical classification 1 or 2 * Scheduled for general anesthesia
Exclusion criteria
* Patients expected to have difficulty with mask ventilation * Patients with oropharyngeal facial deformity * Obese patients (BMI\>30 kg/m2) * Patients with an upper respiratory tract infection * Patients with a history of abdominal surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of gastric insufflation | From the start of anesthesia induction to 3 minutes after anesthesia induction | Incidence of gastric insufflation detected by gastric ultrasound (acoustic shadow phenomenon or comet-tail artifact in the antrum) or by epigastric auscultation (typical 'gurgling' or 'whoosh' sound) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Gastric insufflation detected by ultrasound | 3 minutes after anesthesia induction | Presence of acoustic shadow phenomenon or comet-tail artifact detected by ultrasound |
| Gastric insufflation detected by auscultation | From the start of anesthesia induction to 3 minutes after anesthesia induction | Presence of 'gurgling' or 'whoosh' sound detected by auscultation of the epigastrium. |
| gastric antrum longitudinal diameter (D1) | 3 minutes after anesthesia induction | gastric antrum longitudinal diameter (D1) measured by ultrasound |
| gastric antrum anteroposterior diameter (D2) | 3 minutes after anesthesia induction | gastric antrum anteroposterior diameter (D2) measured by ultrasound |
| gastric antral cross-sectional area (CSA) | 3 minutes after anesthesia induction | gastric antral cross-sectional area (CSA) measured by ultrasound (CSA = (D1 Ⅹ D2 Ⅹ π)/4) |
Other
| Measure | Time frame | Description |
|---|---|---|
| MAP | Every 1 minute during intervention (baseline, 1, 2, 3 min after induction) | Mean arterial pressure |
| Lowest SpO2 | From the start of anesthesia induction to completion of tracheal intubation | Lowest peripheral oxygen saturation during intervention |
| HR | Every 1 minute during intervention (baseline, 1, 2, 3 min after induction) | Heart rate |
| SpO2 | Every 1 minute during intervention (baseline, 1, 2, 3 min after induction) | Peripheral oxygen saturation |
| TV | Every 1 minute during intervention (1, 2, 3 min after induction) | Tidal volume in MV group |
| PIP | Every 1 minute during intervention (1, 2, 3 min after induction) | Peak airway pressure in MV group |
| ETCO2 | Every 1 minute during intervention (1, 2, 3 min after induction) and just after intubation | End tidal CO2 in MV group |
Outcome results
None listed