Airway Effects of PEEP During Anesthesia Induction.

Region Örebro County

Status: Unknown

Conditions: Positive End Expiratory Pressure; Anesthesia Induction; Airway Management; Mask-ventilation

Treatments: Procedure: PEEP-level, driving pressure

Study type: Interventional

Funder types: Other

Identifiers

NCT02920879

PC02

Details and patient eligibility

About

This study investigates airway effects of PEEP during maskventilation at anesthesia induction. Four patient groups will be ventilated with different PEEP and driving pressures to evaluate time to open airway after start of positive pressure maskventilation during anesthesia induction.

Full description

The use of continuous positive pressure (CPAP/PEEP) during pre-oxygenation and mask-ventilation in patients undergoing anesthesia induction is increasing. Continuous positive pressures have several respiratory benefits with well-documented data on both spontaneously breathing patients and intubated patients. However the effects of PEEP on anesthetized patients during mask-ventilation is poorly investigated. In a previous trial the that the investigators conducted, a PEEP-level of 10 cmH2O during mask ventilation after anesthesia induction surprisingly delayed time to alveolar ventilation compared to ZEEP. In order to investigate this phenomenon, four groups of patients will be compared during preoxygenation and mask ventilation after anesthesia induction.

Each group consisting of 30 patients will be pre-oxygenated and mask ventilated with different CPAP/PEEP levels and different driving pressures. Time to open airway is measured as number of respiratory cycles until detection of CO2 on the capnograph.

Enrollment: 120 estimated patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. ≥ 18- ≤ 65 years male or female.
2. Elective surgery under general anesthesia
3. ASA-classification 1-3
4. Signed and dated informed consent

Exclusion criteria

1. BMI > 30
2. Predicted difficult mask-ventilation
3. Known hiatus hernia or GERD

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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120 participants in 4 patient groups

0 CPAP/ 0 PEEP, driving pressure 10

Other group

Description:

Patients will be preoxygenated with a CPAP-level of 0 cmH2O and after anesthesia induction, mask-ventilated with ZEEP and a driving pressure of 10 cmH2O./PEEP-level, driving pressure

Treatment:

Procedure: PEEP-level, driving pressure

0 CPAP/ 0 PEEP driving pressure 20

Other group

Description:

Patients will be pre-oxygenated with a CPAP-level of 0 cmH2O and after anesthesia induction, mask-ventilated with ZEEP and a driving pressure of 20 cmH2O./PEEP-level, driving pressure

Treatment:

Procedure: PEEP-level, driving pressure

10 CPAP / 10 PEEP, driving pressure 10

Other group

Description:

Patients will be pre-oxygenated with a CPAP-level of 10 cmH2O and after anesthesia induction, mask-ventilated with PEEP 10 cmH2O and a driving pressure of 10 cmH2O./PEEP-level, driving pressure

Treatment:

Procedure: PEEP-level, driving pressure

10 CPAP/ 0 PEEP, driving pressure 10

Other group

Description:

Patients will be pre-oxygenated with a CPAP-level of 10 cmH2O and after anesthesia induction, mask-ventilated with ZEEP and a driving pressure of 10 cmH2O./PEEP-level, driving pressure

Treatment:

Procedure: PEEP-level, driving pressure