Postoperative Complications, Sore-throat
Conditions
Keywords
Air-Q Laryngeal İntubating Airway, Oropharyngeal leak pressure, supraglottic airways, Edentulous patients, Geriatric patients
Brief summary
In this study, we aim to investigate the clinical performance, efficacy, and associated complications of the Air-Q Intubating Laryngeal Airway in totally edentulous and dentate geriatric patients.
Detailed description
In the elderly population, the prevalence of totally edentulous patients over the age of 65 exceeds 60%. With aging, parapharyngeal fat deposition increases and contributes to pharyngeal collapse in elderly patients . In elderly patients with total tooth loss, face mask ventilation is difficult because standard face masks do not fit well on edentulous faces. Additionally, during general anesthesia, loss of muscle tone, reduced oropharyngeal air space, posterior displacement of the tongue, and airway obstruction caused by the soft palate and epiglottis all make ventilation challenging . Structural changes in the airway, combined with age-related physiological alterations in respiration, may reduce oxygen saturation, blunt the hypoxic response, and increase the risk of postoperative respiratory complications. Due to age-related acquired changes in pharyngeal muscle activity, the likelihood of skeletal structural abnormalities such as retrognathia-often associated with difficult airways-has been proposed (2). Therefore, these age-related changes may influence the clinical performance of supraglottic airway devices (SADs). Recently, SADs that do not require manual cuff inflation have gained popularity in various clinical settings due to their advantage of eliminating the need for manual cuff inflation and cuff pressure monitoring (5,6). The Air-Q is a supraglottic airway device that connects to an airway tube through a communication port, allowing self-pressurization of the cuff in response to airway pressure. In this study, we aim to investigate the clinical performance, efficacy, and associated complications of the Air-Q Intubating Laryngeal Airway in totally edentulous and dentate geriatric patients.
Interventions
OTHERedentulous geriatric patients
Edentulous geriatric patients will be inserted Air-Q Intubating Airway under general anesthesia.
OTHERdentate geriatric patients
Dentate geriatric patients will be inserted Air-Q Intubating Airway under general anesthesia.
Sponsors
Diskapi Yildirim Beyazit Education and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
65 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* 65-90 year-old patients * Edentulous and gentate 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 |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ease of SGA placement | 3 minutes after induction of anesthesia | Successful SGA placement will be confirmed by visualizing a square waveform on the ventilator and observing chest wall movement. |
| Air-Q insertion time | 3 minutes after induction of anesthesia | Successful Air-Q placement will be confirmed by visualizing a square waveform on the ventilator and observing chest wall movement. |
| 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. |
Other
| Measure | Time frame | Description |
|---|---|---|
| dysphonia | 1 hour postoperatively | The presence or absence of dysphonia will be recorded at the firsth postoperative hour |
| Sore throat | 1 hour postoperatively | The presence or absence of sore throat will be recorded at the 24th postoperative hour |
| Complications during Air-Q removal (emerge) | One minute after Air-Q removal | Complications during SP\_Air-Q and proseal LMA removal (emerge) 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)
Contacts
Primary ContactZeynep Koç
Outcome results
None listed