Adenotonsillectomy
Conditions
Keywords
Adenotonsillectomy in children, Endotracheal tube temperature, Respiratory complications
Brief summary
Adenotonsillectomy is one of the most commonly performed surgical procedures in children worldwide. life-threatening complications such as laryngospasm and bronchospasm may develop in the postoperative period. The aim of this study was to compare the effects of using endotracheal intubation tubes at different temperatures during intubation on respiratory complications in the postoperative period in children undergoing adenotonsillectomy.
Detailed description
Adenotonsillectomy (AT) is one of the most common surgical procedures performed in children. Its incidence has been increasing day by day and has almost doubled since the 1970s. In recent years, with the development of surgical techniques and anesthetic approaches, significant progress has been made in the recovery and postoperative management of these patients and morbidity has decreased significantly. The most feared complications of AT in children are respiratuar complications such as laryngospasm and bronchospasm. These complications can occur during AT or in the postoperative period, requiring rapid response by the anesthesia and surgical team and extensive postoperative monitoring. They may result in increased morbidity and prolonged hospitalization. Different methods including intravenous lidocaine, topical lidocaine, propofol, iv magnesium and the like have been proposed to reduce laryngospasm; different results have been obtained in studies. Thermal softening of endotracheal tubes (ETT) with normal warm saline before intubation has been shown to be significantly effective in reducing sore throat and hoarseness during recovery and postoperatively. The aim of this study was to compare the intraoperative and postoperative respiratory effects of using endotracheal intubation tubes at different temperatures during intubation in children undergoing adenotonsillectomy.
Interventions
OTHER24°C Endotracheal tube
A disposable ETT sized appropriately for the age of the patients will be kept in a 40°C incubator (MIR-162) for 30 minutes. An infrared non-contact thermometer will be used to measure the ETT wall temperature. After removal from the incubator, intubation will be performed as soon as the tubes reach a temperature of 24°C for the T1 group by serial measurements. All intubations will be performed by a single anesthesiologist who is not associated with the study.
OTHER37°C Endotracheal tube
A disposable ETT sized appropriately for the age of the patients will be kept in a 40°C incubator (MIR-162) for 30 minutes. An infrared non-contact thermometer will be used to measure the ETT wall temperature. After removal from the incubator, intubation will be performed as soon as the tubes reach a temperature of 37°C for the T2 group by serial measurements. All intubations will be performed by a single anesthesiologist who is not associated with the study.
Sponsors
Bursa City Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Masking description
The patient and the outcomes assessor will not know the groups
Intervention model description
There are two models for this study. Children intubated with an endotracheal tube which 24° celcius (Group T24), Children intubated with an endotracheal tube which 37° celcius (Group T37)
Eligibility
Sex/Gender
ALL
Age
3 Years to 9 Years
Healthy volunteers
No
Inclusion criteria
* Parents who agreed to participate in the study * Children undergoing adenotonsillectomy * ASA 1 and 2 class patients
Exclusion criteria
* Emergency surgery * Children with a history of difficult airway * Children who have had upper airway surgery * Presence or suspicion of upper or lower respiratory tract infection * History of cardiac and respiratory diseases * Patients with craniofacial malformations
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Rate of laryngospasm | From extubation until postoperative 2. hour | The rates of laryngospasm occurring in the participants will be determined and compared between the 2 groups |
| Rate of bronchospasm | From extubation until postoperative 2. hour | The rates of bronchospasm occurring in the participants will be determined and compared between the 2 groups |
| Rate of desaturation | From extubation until postoperative 2. hour | The rates of desaturation occurring in the participants will be determined and compared between the 2 groups |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Heart rate | 7 times (1 minute(min) before induction of anaesthesia, 5 seconds(sec) after intubation, 5 min and 15 min after the start of surgery, 5 sec after the completion of surgery, 5 sec after extubation, 5 sec before transfer to post-anaesthesia care) | Heart rate (HR) (bpm) will be recorded and data will be compared between groups |
| Mean arterial pressure (MAP) mmHg | 7 times (1 minute(min) before induction of anaesthesia, 5 seconds(sec) after intubation, 5 min and 15 min after the start of surgery, 5 sec after the completion of surgery, 5 sec after extubation, 5 sec before transfer to post-anaesthesia care) | Mean arterial pressure (MAP) (mmHg) will be recorded and data will be compared between groups |
| Oxygen saturation | 7 times (1 minute(min) before induction of anaesthesia, 5 seconds(sec) after intubation, 5 min and 15 min after the start of surgery, 5 sec after the completion of surgery, 5 sec after extubation, 5 sec before transfer to post-anaesthesia care) | Oxygen saturation (SpO2), (%) will be recorded and data will be compared between groups |
| Intraopearative anaesthesia machine respiratory data | 4 times measurement (5 seconds after intubation, 5 minutes after the start of surgery, 15 minutes after the start of surgery, 5 seconds after the completion of surgery) | End-tidal carbon dioxide (EtCO2) (mmHg) will be recorded and data will be compared between groups |
| Intraopearative anaesthesia machine respiratory data 2 | 4 times measurement (5 seconds after intubation, 5 minutes after the start of surgery, 15 minutes after the start of surgery, 5 seconds after the completion of surgery) | Maximum pressure measured at end inspiration (Ppeak) will be recorded and data will be compared between groups Mean airway pressure (Pmean) will be recorded and data will be compared between groups |
Countries
Turkey (Türkiye)
Outcome results
None listed