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Apneic Oxygenation during simulated prolonged difficult laryngoscopy: Comparison of nasal prongs versus nasopharyngeal catheter: A prospective randomized controlled study
BACKGROUND: Apneic oxygenation by insufflating O(2) through nasal prongs (NP) and nasopharyngeal catheter (NC) has been proven to be effective. We conducted this study to compare the relative efficacy of these two techniques in a simulated difficult airway situation. OBJECTIVE: The objective of this...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Medknow Publications & Media Pvt Ltd
2014
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173586/ https://www.ncbi.nlm.nih.gov/pubmed/25886106 http://dx.doi.org/10.4103/0259-1162.128911 |
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author | Achar, Shreepathi Krishna Pai, Archana Jagdish Shenoy, U. Kailasnath |
author_facet | Achar, Shreepathi Krishna Pai, Archana Jagdish Shenoy, U. Kailasnath |
author_sort | Achar, Shreepathi Krishna |
collection | PubMed |
description | BACKGROUND: Apneic oxygenation by insufflating O(2) through nasal prongs (NP) and nasopharyngeal catheter (NC) has been proven to be effective. We conducted this study to compare the relative efficacy of these two techniques in a simulated difficult airway situation. OBJECTIVE: The objective of this study is to evaluate the influence of two techniques of apneic oxygenation (NP vs. NC) on the duration of oxygen saturation ≥95% during simulated prolonged difficult laryngoscopy. METHODS: A randomized non-blinded study was conducted in 56 adult patients, 28 in each group belonging to American Society of Anesthesiologists physical status class I and II scheduled for elective surgical procedures under general endotracheal anesthesia randomized to either NC or NP group. After pre-oxygenating for an end tidal oxygen concentration of 90% and induction, ability to mask ventilate was checked and paralyzed with rocuronium. Apneic oxygenation using 5 L/min of O(2) was established either by NP or NC. After laryngoscopy the laryngoscope was withdrawn to simulate a Grade 4 laryngoscopy and held in this position for an apnea time (T(1)) of 10 min with SpO(2) maintained at ≥95% or until SpO(2) dropped to < 95%, whichever is earlier. An arterial blood gas analysis was performed at the end of T(1). Desaturation to < 95% were compared between the groups using Chi-square test (P < 0.05 as significant). Arterial blood gas analysis among those who sustained T(1) for 10 min between the groups were compared using independent sample t-test (P < 0.05 was considered as significant). None of patients were excluded from the study. RESULTS: In NP group nine patients desaturated as against none in the NC group (P = 0.001). Arterial blood gas analysis among non-desaturated patients was comparable with respect to PO(2), PCO(2) and pH. CONCLUSION: Nasopharyngeal catheter is a better device than nasal prongs in maintaining safe oxygenation during apnea in a simulated prolonged difficult laryngoscopy. |
format | Online Article Text |
id | pubmed-4173586 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-41735862014-10-22 Apneic Oxygenation during simulated prolonged difficult laryngoscopy: Comparison of nasal prongs versus nasopharyngeal catheter: A prospective randomized controlled study Achar, Shreepathi Krishna Pai, Archana Jagdish Shenoy, U. Kailasnath Anesth Essays Res Original Article BACKGROUND: Apneic oxygenation by insufflating O(2) through nasal prongs (NP) and nasopharyngeal catheter (NC) has been proven to be effective. We conducted this study to compare the relative efficacy of these two techniques in a simulated difficult airway situation. OBJECTIVE: The objective of this study is to evaluate the influence of two techniques of apneic oxygenation (NP vs. NC) on the duration of oxygen saturation ≥95% during simulated prolonged difficult laryngoscopy. METHODS: A randomized non-blinded study was conducted in 56 adult patients, 28 in each group belonging to American Society of Anesthesiologists physical status class I and II scheduled for elective surgical procedures under general endotracheal anesthesia randomized to either NC or NP group. After pre-oxygenating for an end tidal oxygen concentration of 90% and induction, ability to mask ventilate was checked and paralyzed with rocuronium. Apneic oxygenation using 5 L/min of O(2) was established either by NP or NC. After laryngoscopy the laryngoscope was withdrawn to simulate a Grade 4 laryngoscopy and held in this position for an apnea time (T(1)) of 10 min with SpO(2) maintained at ≥95% or until SpO(2) dropped to < 95%, whichever is earlier. An arterial blood gas analysis was performed at the end of T(1). Desaturation to < 95% were compared between the groups using Chi-square test (P < 0.05 as significant). Arterial blood gas analysis among those who sustained T(1) for 10 min between the groups were compared using independent sample t-test (P < 0.05 was considered as significant). None of patients were excluded from the study. RESULTS: In NP group nine patients desaturated as against none in the NC group (P = 0.001). Arterial blood gas analysis among non-desaturated patients was comparable with respect to PO(2), PCO(2) and pH. CONCLUSION: Nasopharyngeal catheter is a better device than nasal prongs in maintaining safe oxygenation during apnea in a simulated prolonged difficult laryngoscopy. Medknow Publications & Media Pvt Ltd 2014 /pmc/articles/PMC4173586/ /pubmed/25886106 http://dx.doi.org/10.4103/0259-1162.128911 Text en Copyright: © Anesthesia: Essays and Researches http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Achar, Shreepathi Krishna Pai, Archana Jagdish Shenoy, U. Kailasnath Apneic Oxygenation during simulated prolonged difficult laryngoscopy: Comparison of nasal prongs versus nasopharyngeal catheter: A prospective randomized controlled study |
title | Apneic Oxygenation during simulated prolonged difficult laryngoscopy: Comparison of nasal prongs versus nasopharyngeal catheter: A prospective randomized controlled study |
title_full | Apneic Oxygenation during simulated prolonged difficult laryngoscopy: Comparison of nasal prongs versus nasopharyngeal catheter: A prospective randomized controlled study |
title_fullStr | Apneic Oxygenation during simulated prolonged difficult laryngoscopy: Comparison of nasal prongs versus nasopharyngeal catheter: A prospective randomized controlled study |
title_full_unstemmed | Apneic Oxygenation during simulated prolonged difficult laryngoscopy: Comparison of nasal prongs versus nasopharyngeal catheter: A prospective randomized controlled study |
title_short | Apneic Oxygenation during simulated prolonged difficult laryngoscopy: Comparison of nasal prongs versus nasopharyngeal catheter: A prospective randomized controlled study |
title_sort | apneic oxygenation during simulated prolonged difficult laryngoscopy: comparison of nasal prongs versus nasopharyngeal catheter: a prospective randomized controlled study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173586/ https://www.ncbi.nlm.nih.gov/pubmed/25886106 http://dx.doi.org/10.4103/0259-1162.128911 |
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