Airway Complication of Anesthesia, Postoperative Complications, Sore-throat
Conditions
Keywords
Air-Q SP İntubating Laryngeal Airway, oropharyngeal leak pressure, supraglottic airways
Brief summary
Some previous studies have reported structural and physiological changes in the pharyngeal airway and UES with aging . It has been found that the shape and size of the pharyngeal airway in elderly individuals differ from those of young adults. This study aims to compare the effectiveness of the Air-Q laryngeal mask airway (LMA) across different age groups (young, middle-aged, and elderly patients) and to evaluate complications associated with supraglottic airways (SGA).
Detailed description
Supraglottic airway devices (SGA) used perioperatively are known to require lower anesthetic depth and result in fewer airway complications such as coughing and sore throat after awakening from anesthesia compared to endotracheal intubation. Due to these advantages, SGAs are particularly beneficial in elderly patients, as they experience a reduction in functional reserves, are more affected by cardiopulmonary diseases, and are more sensitive to anesthetic drugs SGAs are inserted through the oral route, and the SGA cuff is placed between the base of the tongue, hypopharynx, and upper esophageal sphincter (UES) to provide proper ventilation. Some previous studies have reported structural and physiological changes in the pharyngeal airway and UES with aging . It has been found that the shape and size of the pharyngeal airway in elderly individuals differ from those of young adults. Additionally, there are changes in the function and structure of the UES with age. These age-related changes may affect the performance of SGAs in the elderly population. Recently, SGAs that do not require manual cuff inflation have been used more frequently in various clinical settings due to the advantages of eliminating the need for manual cuff inflation and cuff pressure monitoring. The Air-Q is connected to an airway tube through a communication port that allows for self-regulation of cuff pressure in response to airway pressure.
Interventions
OTHERGroup 1 will include patients aged 18-40 years
Group 1 will include patients aged 18-40 years.
OTHERGroup 2 will include patients aged 40-64 years
Group 2 will include patients aged 40-64 years, and finally.
OTHERGroup 3 will include patients aged 65-85 years
Group 3 will include patients aged 65-85 years.
Sponsors
Diskapi Yildirim Beyazit Education and Research Hospital
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* 18-85 year-old patients * American Society of Anesthesiologist Physical Status classification I-III, * Undergoing an elective operation under general anesthesia in our hospital
Exclusion criteria
* Predicted difficult airway (Mallampati class 4, mouth opening \< 3 cm, or thyromental distance \< 6 cm) * body mass index (BMI) \> 40 kg/m2 * Patients with a high risk of aspiration (e.g., history of gastrectomy, gastroesophageal reflux disease, or hiatal hernia), * Unstable vital signs, * Cervical spine problems, Respiratory complications (e.g. recent pneumonia).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Measurement of oropharyngeal leak pressure (OLP) | One minute after successful LMA placement | One minute after successful LMA placement and fixation, oropharyngeal leak pressure (OLP) will be measured by setting the adjustable pressure limiting valve (APL) to 40 mmHg and maintaining a fresh gas flow of 3 L/min. The OLP will be recorded as the pressure at which an audible leak sound is heard from the mouth. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ease of LMA placement | 3 minutes after induction of anesthesia | The ease of LMA placement will be scored by the anesthesiologist on a scale from 1 to 4 (1: Successful on the first attempt with no resistance from the tissues; 2: Successful on the first attempt but with some tissue resistance during placement; 3: Moderate tissue resistance; 4: Failure to place the LMA). |
| maneuvers required for successful ventilation | 3 minutes after induction of anesthesia | It will be recorded whether any further maneuvers are required: Gentle pushing or pulling of the LMA to adjust its depth, jaw-thrust maneuver, and flexion or extension of the head. |
| fiberoptic view grading | 3 minutes after induction of anesthesia | The Brimacombe score will be used to evaluate the view obtained with fiberoptic bronchoscopy. 1: Vocal cords are not visible; 2: Vocal cords and anterior epiglottis are visible; 3: Vocal cords and posterior epiglottis are visible; 4: Vocal cords are visible. |
| SP Air-Q insertion time | 3 minutes after induction of anesthesia | Successful LMA placement will be confirmed by visualizing a square waveform on the ventilator and observing chest wall movement. |
| sore throat | 1-24 hours postoperatively | Postoperative complication |
| dysphonia | 1-24 hours postpoeratively | Postoperative complication |
| Complications during SP_Air-Q removal (emerge) | One minute after SP Air-Q removal | such as breath-holding during emergence, airway obstruction, coughing, hypoxia (SpO2 \< 90%), vomiting, lip-tongue-teeth trauma, and bleeding, will be recorded |
Countries
Turkey (Türkiye)
Outcome results
None listed