Classic and Modified Rapid Sequence Induction for Prevention of Gastric Content Regurgitation

Nanjing Medical University

Status: Completed

Conditions: Rapid Sequence Induction

Treatments: Procedure: Classic rapid sequence induction; Procedure: Modified rapid sequence induction

Study type: Observational

Funder types: Other

Identifiers

NCT04312425

2020-SR-093

Details and patient eligibility

About

Induction of anesthesia induces a loss of protective upper airway reflexes and is associated with gastric content regurgitation. Emergency surgery bears a higher risk of gastric content regurgitation because of full stomach, delayed gastric emptying, intestinal obstruction, stroke or other factors. Rapid sequence induction (RSI) of anesthesia was recommended to minimize the risk of regurgitation and aspiration. Classic RSI scheme mainly includes the use of short-acting sedatives and muscle relaxant, together with a manual pressure to the cricoid cartilage (Sellick maneuver) which aims at compressing the esophagus to avoid regurgitation. Though widely recommended, the scheme has been controversial for years. Our department modified the scheme and put it into use in day shift emergency surgery since March 1, 2018. This retrospective analysis is aimed at comparing the effect of classic and modified rapid sequence induction in prevention of gastric content regurgitation in emergency surgery under general anesthesia.

Enrollment: 8,601 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patients receive emergency surgery under general anesthesia March 1, 2015 to February 29, 2020
• Eighteen years or older

Exclusion criteria

• Trachea intubation status on admission
• Tracheotomy
• Bronchoscope surgery
• General anesthesia with laryngeal mask
• Awake intubation

Trial design

8,601 participants in 2 patient groups

Group C

Description:

General anesthesia was induced with classic rapid sequence induction protocol.

Treatment:

Procedure: Classic rapid sequence induction

Group M

Description:

General anesthesia was induced with modified rapid sequence induction protocol.

Treatment:

Procedure: Modified rapid sequence induction