- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02311153
Safety and Efficacy of Laryngeal Mask Airways in Sinonasal Surgery
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
LMA's have been studied in a wide range of otolaryngologic procedures, and are generally safe and accepted by both anesthesia providers and surgeons alike, as a safe mode of airway management when delivering general anesthesia. In sinonasal surgery, however, there are more concerns regarding the use of LMA's for airway management. Due to the nature of sinonasal procedures, the patient is exposed to blood and secretions that may drip/flow from the nasal cavity into the oropharynx and potentially into the upper and lower airways if not protected adequately. Additionally, often times, manipulation of the patient's head throughout the procedure is encountered to improve operative positioning. As a result, both surgeons and anesthesiologists have been hesitant to utilize LMA's in these types of surgeries despite documented benefits of increased patient comfort, fewer hemodynamic fluctuations during induction of anesthesia, and better controlled emergence when using LMA's.
Specific Aims The overall purpose of this study is to demonstrate the ability to provide safe and effective ventilation and airway protection with a laryngeal mask airway (LMA) during sinonasal surgery, by directly comparing them to endotracheal intubation in a prospective randomized single-blind study.
Aim 1: Analyze and compare the incidence and severity of airway contamination/aspiration of blood and secretions during sinonasal surgery and reveal any statistically significant difference between LMA and endotracheal intubation.
Aim 2: Analyze and compare the incidence of various outcome measures including laryngospasm, bronchospasm, anesthesia time, recovery time, post-op pain medication requirements, and airway complications between LMA and endotracheal intubation.
Aim 3: Analyze and compare both patient comfort and surgeon satisfaction after procedure between LMA and endotracheal intubation groups.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Tennessee
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Nashville, Tennessee, United States, 37232
- Vanderbilt University Medical Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Adult patients (18 yo or older) undergoing elective sinonasal procedures including rhinoplasty, septoplasty, and paranasal sinus surgery estimated blood loss will be less than 300cc and the length of the procedure will be expected to last 2 hours or less
- American Society of Anesthesiologists (ASA) scores 1-3
- Mallampati classification 1-3
Exclusion Criteria:
- Currently pregnant
- History of obstructive sleep apnea with history of difficulty with ventilation
- Mouth opening less than 3cm
- Indications for fiberoptic intubation present
- Upper aerodigestive tract mass or malignancy
- Procedure deemed emergent
- Severe gastroesophageal reflux, severe cardiac, pulmonary, renal or hepatic co-morbidities
- Unable to consent to study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Endotracheal intubation
Endotracheal intubation for airway management and ventilation during sinonasal surgical procedure
|
Patient is intubated for airway protection and ventilation with the Mallinckrodt ETT.
|
Experimental: Laryngeal mask airway
Laryngeal mask for airway management and ventilation during sinonasal surgical procedure
|
Laryseal Laryngeal mask airway is used to provide airway protection and ventilation.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Participants With Presence or Absence of Blood/Secretions in Trachea and Larynx Based on Soiling Score
Time Frame: intraoperative, within about 1 hour
|
Presence or absence of blood/secretions as noted in trachea and larynx.
Patients were evaluated based on a soiling score completed by the surgeon, ranging from 0 (no contamination or soilage) to 3 (contamination of the tube/bloody secretions).
|
intraoperative, within about 1 hour
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Anesthesia Time in Minutes
Time Frame: beginning and end of anesthesia (approximately 2 hours)
|
Start and stop time of anesthesia as recorded in anesthesia record
|
beginning and end of anesthesia (approximately 2 hours)
|
Recovery Time in Minutes
Time Frame: time spent in recovery room after surgery (approximately 4 hours)
|
Minutes spent in recovery room as recorded in the recovery room record
|
time spent in recovery room after surgery (approximately 4 hours)
|
Presence of Laryngeal Spasm
Time Frame: From start of anesthesia through hospital discharge (approximately 6 hours)
|
As recorded in anesthesia care record
|
From start of anesthesia through hospital discharge (approximately 6 hours)
|
Post-op Pain Med Requirements
Time Frame: 48 hour medicine requirement
|
Recording pain medications given to patient as noted in the recovery room records and medication administration record
|
48 hour medicine requirement
|
Presence or Absence of Airway Complications
Time Frame: Start of surgery through hospital discharge (approximately 6 hours)
|
Start of surgery through hospital discharge (approximately 6 hours)
|
Collaborators and Investigators
Investigators
- Principal Investigator: Justin Turner, MD, PhD, Vanderbilt University Medical Center
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- 141421
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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