A Single-center, Prospective Study for Mechanism and Risk Factors of Tracheal Tube-related Tongue Injury

China-Japan Friendship Hospital

Status: Active, not recruiting

Conditions: Tracheal Tube-related Tongue Injury

Treatments: Device: Tracheal tube-tongue pressure is measured using a computerized occlusal analysis system based on T-Scan® technique, suitable for multi-point real-time monitoring of intraoral pressure.

Study type: Observational

Funder types: Other

Identifiers

NCT05987293

ChinaJapanFHAnesth

Details and patient eligibility

About

Article Summary

1. Tracheal tube-related tongue injury is a common clinical complication that would lead to serious events such as dysphagia, respiratory dysfuncion and macroglossia.
2. There is a lack of qualitative and quantitative risk assessment of tracheal tube-related tongue injury.
3. This is a protocol of a single-center, prospective, paralled-group clinical trial based on the measurement of dynamic changes in pressure between the tracheal tube and the tongue in different position during the surgery.
4. The primary endpoint is tracheal tube-related tongue injury, secondary outcomes include the time to first successful recovery of oral intake of fluids and solid food and airway-related events.
5. This trial aims to find the best indicators for tracheal tracheal tube-related tongue injury and to provide solid basis for optimizing airway protection strategies and surgical positioning.

Full description

Background Tracheal tube-related tongue injury can lead to post-intubation pharyngeal dysfunction, postoperative macroglossia, or stridor after extubation. Possible mechanisms include increased oral pressure, obstruction of venous and lymphatic return in the neck, leading to severe throat pain, dysphagia, and respiratory function impairment. There is a lack of indicators and clinical awareness of this issue. Therefore we have designed this study to accurately monitor the tracheal tube-tongue pressure in different surgical position during general anesthesia.

Method This is a prospective, single-center observational study. Fifty-four patients undergoing elective surgery in general anesthesia for more than 2 hours with endotracheal tube applied will be enrolled. Patients will be divided into supine position (Supine group) and the high-risk positions (Flexion group) groups. Dynamic changes in pressure between the tracheal tube and the tongue are measured. All patients will be followed up until 7 days after operation. Primary endpoint is tracheal tube-related tongue injury. Secondary outcomes include the time to first successful recovery of oral intake of fluids and solid food, and airway-related events.

Discussion The study aims to explore the risk factors and pressure thresholds for tracheal tracheal tube-related tongue injury.

Enrollment: 94 patients

Sex: All

Ages: 18 to 85 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

1. ASA I-III
2. Age 18-85 years old
3. Scheduled for elective surgery with tracheal intubation under general anesthesia, with operation duration ≥2 hours
4. The intended surgical position will be supine, prone, cervical traction or beach chair position
5. Obtained informed consent

Exclusion criteria

1. Informed consent is not obtained
2. Maxillofacial surgeries or other surgeries involving the oral cavity and upper airway
3. History of head and neck radiotherapy
4. Deformity, trauma, infection and active bleeding exist in the mouth and tongue
5. Airway hyperresponsiveness, active asthma, acute exacerbation of chronic obstructive pulmonary disease, laryngeal osteomalacia
6. Respiratory insufficiency, moderate to severe ventilation or diffusion dysfunction
7. Existing chronic sore throat, recurrent laryngeal nerve injury, dysarthria, dysphagia, severe gastroesophageal reflux, upper esophageal sphincter dysfunction, cardiac stenosis and other basic diseases
8. Postoperative total parenteral nutrition therapy is planned

Trial design

94 participants in 2 patient groups

Supine group

Description:

Fifty-four patients undergoing elective surgery in general anesthesia for more than 2 hours with endotracheal tube applied in China-Japan Friendship Hospital will be enrolled (See in Sample Size calculation). Patients will be divided into two groups according to the surgery: supine position (Supine group)

Treatment:

Device: Tracheal tube-tongue pressure is measured using a computerized occlusal analysis system based on T-Scan® technique, suitable for multi-point real-time monitoring of intraoral pressure.

Flexion group

Description:

The high-risk positions (Flexion group) which include patients scheduled for surgery under the prone position, cervical traction position, and beach chair position.

Treatment:

Device: Tracheal tube-tongue pressure is measured using a computerized occlusal analysis system based on T-Scan® technique, suitable for multi-point real-time monitoring of intraoral pressure.