Effect of Head Position on MACEI of Sevoflurane in Children With Obstructive Airway (MACEI)
10 de mayo de 2018 actualizado por: Jingjie Li, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University
Effect of Head Position on Minimum Alveolar Concentration of Endotracheal Intubation（MACEI）of Sevoflurane in Children With Obstructive Airway
Children scheduled for tonsillectomy surgery were recruited into the study.
General anesthesia was induced with 8% sevoflurane inhaled with 8 l.min-1 of oxygen via mask, followed by adjustment of inspired sevoflurane to the target concentration based on the result in previous patient at which laryngoscopy and tracheal intubation were attempted and maintained for 12 min.
All responses to tracheal intubation were assessed.
At the end of the procedure, sevoflurane was titrated to the target concentration, which was kept constant for 12 min before a standard stimulus was applied to determine whether the children was awake.
The Dixon's 'up and down'method was used to determine progression of subsequent concentrations.The aim of this study was to determine whether the minimum alveolar concentration of endotracheal intubation（MACEI）of sevoflurane in children with obstructive airway are different from that observed in normal children.
Descripción general del estudio
Estado
Desconocido
Condiciones
Intervención / Tratamiento
Descripción detallada
38 patients American Society of Anesthesiologists (ASA) class I or II aged 2-8 years undergoing tonsillectomy surgery were randomized to either the patient's head in the neutral position or 30 degree rotated lateral position.
All patients were preoxygenated using 100% oxygen with a normal tidal volumen for 3 min.
The circuit was primed with sevoflurane 8% at a fresh gas flow of 8 Litre/min （L/min） for 1 min.
Anaesthesia was induced with inhaled sevoflurane up to 5% in oxygen via facemask with fresh gas flow at 6 L/min.After loss of consciousness, the inspired concentration of sevoflurane was maintained 10-12min a predetermined end-tidal concentration.
A single experienced anaesthetist in the use of endotracheal devices inserted the devices according to the manufacturer's recommendations.
Neuromuscular blocking agents and other intravenous anesthetics were not given.
One nurse, who was blinded to the anaesthetic concentration, classified responses by the patient to tracheal intubation as either "movement" or "not movement".
Assesment was made for jaw relaxation and graded with intubation score.
The sum of intubation scores >4 was defined as a failure of insertion.
The end-tidal (ET) sevoflurane concentration used for each patient was determined using the Dixon's up-and-down method.
The ratio of the end-tidal to predetermined end-tidal concentrations was maintained at 0.95-1.0
for at least 10 minutes to establish equilibration before device insertion was attempted.
The first patient received a 5.0% sevoflurane concentration and the step size of increase/decrease was 0.5%.
If the endotracheal device insertion was successful, sevoflurane concentration for the next patient was decrease by 0.5%.
If not, sevoflurane concentration was increased by the same amount for the next patient.
For their comfort, patients experiencing movement received a 2 mg/kg bolus dose of propofol,fentanyl 2.0ug/kg and rocuronium 0.6mg/kg.If the endotracheal device insertion was successful,fentanyl 2.0ug/kg and rocuronium 0.6mg/kg was also administered.
Tipo de estudio
Intervencionista
Inscripción (Anticipado)
38
Fase
- No aplica
Contactos y Ubicaciones
Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.
Ubicaciones de estudio
-
-
Shanghai
-
Shanghai, Shanghai, Porcelana
- Shanghai9 Hospital
-
-
Criterios de participación
Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.
Criterio de elegibilidad
Edades elegibles para estudiar
2 años a 8 años (Niño)
Acepta Voluntarios Saludables
No
Géneros elegibles para el estudio
Todos
Descripción
Inclusion Criteria:
- class I or II
- children aged 2-8 years
- children with obstruction airway under general anesthesia undergoing tonsillectomy surgery
- signed informed consent
Exclusion Criteria:
- Patients with a history of adverse reactions to sevoflurane
- Patients with a potentially difficult airway (Mallampati III or IV, a limited mouth opening and/or cervical spine disease)
- Patients with reactive airway disease
- Signs of upper respiratory infection
- Violate experimental scheme
- refused to participate
Plan de estudios
Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Otro
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Doble
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
|---|---|
|
Experimental: 30 degree rotated lateral position
19 patients American Society of Anesthesiologists (ASA) class I or II aged 2-8 years undergoing tonsillectomy surgery were randomized to the head in 30 degree rotated lateral position.
The end-tidal (ET) sevoflurane concentration used for each patient was determined using the Dixon's up-and-down method.
The ratio of the end-tidal to predetermined end-tidal concentrations was maintained at 0.95-1.0
for at least 10 minutes to establish equilibration before device insertion was attempted.
The first patient received a 5.0% sevoflurane concentration and the step size of increase/decrease was 0.5%.
|
38 patients American Society of Anesthesiologists (ASA) class I or II aged 2-8 years undergoing tonsillectomy surgery were randomized to either the patient's head in the neutral position or 30 degree rotated lateral position.
The end-tidal (ET) sevoflurane concentration used for each patient was determined using the Dixon's up-and-down method.
The ratio of the end-tidal to predetermined end-tidal concentrations was maintained at 0.95-1.0
for at least 10 minutes to establish equilibration before device insertion was attempted.
The first patient received a 5.0% sevoflurane concentration and the step size of increase/decrease was 0.5%.
Otros nombres:
|
|
Comparador activo: neutral position
19 patients American Society of Anesthesiologists (ASA) class I or II aged 2-8 years undergoing tonsillectomy surgery were randomized to the head in the neutral position.The end-tidal (ET) sevoflurane concentration used for each patient was determined using the Dixon's up-and-down method.
The ratio of the end-tidal to predetermined end-tidal concentrations was maintained at 0.95-1.0
for at least 10 minutes to establish equilibration before device insertion was attempted.
The first patient received a 5.0% sevoflurane concentration and the step size of increase/decrease was 0.5%.
|
38 patients American Society of Anesthesiologists (ASA) class I or II aged 2-8 years undergoing tonsillectomy surgery were randomized to either the patient's head in the neutral position or 30 degree rotated lateral position.
The end-tidal (ET) sevoflurane concentration used for each patient was determined using the Dixon's up-and-down method.
The ratio of the end-tidal to predetermined end-tidal concentrations was maintained at 0.95-1.0
for at least 10 minutes to establish equilibration before device insertion was attempted.
The first patient received a 5.0% sevoflurane concentration and the step size of increase/decrease was 0.5%.
Otros nombres:
|
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
minimum alveolar anesthetic concentration of endotracheal intubation
Periodo de tiempo: The sevoflurane concentration is obtained when tracheal intubated immediately.
|
To compare the minimum alveolar anesthetic concentration of endotracheal intubation required for different head position in children with obstructive airway.
|
The sevoflurane concentration is obtained when tracheal intubated immediately.
|
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
intubation score
Periodo de tiempo: The intubation score is obtained when tracheal intubation was inserted immediately.
|
One nurse, who was blinded to the anaesthetic concentration, classified responses by the patient to tracheal intubation as either "movement" or "not movement".
Assesment was made for jaw relaxation and graded with intubation score.
The sum of intubation scores >4 was defined as a failure of insertion.
|
The intubation score is obtained when tracheal intubation was inserted immediately.
|
|
blood pressure include systolic and diastolic in mmHg
Periodo de tiempo: Baseline and every 1 minutes until 10 minutes after insertion of the endotracheal intubation.
|
To compare the evolution of blood pressure include systolic and diastolic during different head position group.
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Baseline and every 1 minutes until 10 minutes after insertion of the endotracheal intubation.
|
|
heart rate in bpm
Periodo de tiempo: Baseline and every 1 minutes until 10 minutes after insertion of the endotracheal intubation.
|
To compare the evolution of heart rate during different head position group.
|
Baseline and every 1 minutes until 10 minutes after insertion of the endotracheal intubation.
|
|
bispectral index（BIS）, number from 100 (awake) to 40-60(anesthetic status)
Periodo de tiempo: Baseline and every 1 minutes until 10 minutes after insertion of the endotracheal intubation.
|
To compare the evolution of of bispectral index values during different head position group.
|
Baseline and every 1 minutes until 10 minutes after insertion of the endotracheal intubation.
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Colaboradores e Investigadores
Aquí es donde encontrará personas y organizaciones involucradas en este estudio.
Investigadores
- Silla de estudio: Li Jing Jie, M.D., Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University
Publicaciones y enlaces útiles
La persona responsable de ingresar información sobre el estudio proporciona voluntariamente estas publicaciones. Estos pueden ser sobre cualquier cosa relacionada con el estudio.
Publicaciones Generales
- Thwaites A, Edmends S, Smith I. Inhalation induction with sevoflurane: a double-blind comparison with propofol. Br J Anaesth. 1997 Apr;78(4):356-61. doi: 10.1093/bja/78.4.356.
- Tanaka S, Tsuchida H, Nakabayashi K, Seki S, Namiki A. The effects of sevoflurane, isoflurane, halothane, and enflurane on hemodynamic responses during an inhaled induction of anesthesia via a mask in humans. Anesth Analg. 1996 Apr;82(4):821-6. doi: 10.1097/00000539-199604000-00025.
- Yasuda N, Lockhart SH, Eger EI 2nd, Weiskopf RB, Liu J, Laster M, Taheri S, Peterson NA. Comparison of kinetics of sevoflurane and isoflurane in humans. Anesth Analg. 1991 Mar;72(3):316-24. doi: 10.1213/00000539-199103000-00007.
- Wajima Z, Inoue T, Yoshikawa T, Imanaga K, Ogawa R. Changes in hemodynamic variables and catecholamine levels after rapid increase in sevoflurane or isoflurane concentration with or without nitrous oxide under endotracheal intubation. J Anesth. 2000;14(4):175-9. doi: 10.1007/s005400070001.
- Goff MJ, Arain SR, Ficke DJ, Uhrich TD, Ebert TJ. Absence of bronchodilation during desflurane anesthesia: a comparison to sevoflurane and thiopental. Anesthesiology. 2000 Aug;93(2):404-8. doi: 10.1097/00000542-200008000-00018.
- Helbo-Hansen S, Ravlo O, Trap-Andersen S. The influence of alfentanil on the intubating conditions after priming with vecuronium. Acta Anaesthesiol Scand. 1988 Jan;32(1):41-4. doi: 10.1111/j.1399-6576.1988.tb02685.x.
- Makkar JK, Ghai B, Bhardwaj N, Wig J. Minimum alveolar concentration of desflurane with fentanyl for laryngeal mask airway removal in anesthetized children. Paediatr Anaesth. 2012 Apr;22(4):335-40. doi: 10.1111/j.1460-9592.2011.03712.x. Epub 2011 Oct 21.
Fechas de registro del estudio
Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.
Fechas importantes del estudio
Inicio del estudio (Actual)
1 de enero de 2018
Finalización primaria (Actual)
1 de enero de 2018
Finalización del estudio (Anticipado)
31 de octubre de 2018
Fechas de registro del estudio
Enviado por primera vez
30 de abril de 2018
Primero enviado que cumplió con los criterios de control de calidad
10 de mayo de 2018
Publicado por primera vez (Actual)
11 de mayo de 2018
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
11 de mayo de 2018
Última actualización enviada que cumplió con los criterios de control de calidad
10 de mayo de 2018
Última verificación
1 de mayo de 2018
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- 2018-15-T15
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
INDECISO
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
No
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
No
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