Optimal Head Rotation and External Landmark for Internal Jugular Vein Cannulation After Placement of Proseal Laryngeal Mask Airway
Recently, laryngeal mask airway (LMA) placements are frequently performed for general anesthesia. The investigators occasionally encounter a clinical situation to perform internal jugular vein (IJV) cannulation after LMA insertion, especially for difficult airway in subjects undergoing major surgery. However, anatomic relations of IJV and common carotid artery (CCA) in patient with LMA placement have been reported to be different from those in patients with endotracheal tube. The degree of overlapping of the right IJV and CCA after LMA placement was greater than before LMA placement. Furthermore, there are many cases of complete overlapping right IJV and CCA after LMA placement. Therefore, the risk of puncturing CCA increases when the investigators try to cannulate IJV after LMA placement. Furthermore, the central landmark commonly used for IJV cannulation was proved to show low success rate after LMA placement in previous report.
The investigators carefully examined the anatomic relations of IJV and CCA after LMA insertion with ultrasonography, and found that the degree of overlapping is different according to the degree of head rotation. The investigators postulated that if the degree of overlapping is different according to the degree of head rotation after LMA insertion, the investigators can find the angle of head rotation for least overlapping and reduce the risk of CCA puncture. Therefore, the investigators tried (1) to find the optimal head rotation angle appropriate for puncturing IJV after LMA placement, and (2) to find suitable landmark adequate for IJV cannulation after LMA placement.
調査の概要
詳細な説明
研究の種類
入学 (実際)
連絡先と場所
研究場所
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-
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Seoul、大韓民国、135-710
- Samsung Medical Center
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
説明
Inclusion Criteria:
- patients undergoing general anesthesia with laryngeal mask airway insertion
Exclusion Criteria:
- patients undergoing emergency surgery
- patients with anatomical problem of airway
- anticipated difficult airway
- patients with hemodynamic unstability
- patients with severe cardiopulmonary disease
研究計画
研究はどのように設計されていますか?
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
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LMA group
patients undergoing general anesthesia with LMA insertion
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Repeated ultrasonographic examination according to the degree of head rotation (examination of overlap index of internal jugular vein and common carotid artery, and accuracy of external landmark of jugular cannulation)
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E-tube group
patients undergoing general anesthesia with e-tube
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Repeated ultrasonographic examination according to the degree of head rotation (examination of overlap index of internal jugular vein and common carotid artery, and accuracy of external landmark of jugular cannulation)
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この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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overlap index
時間枠:at 5 min after anesthesia induction
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The overlap index was derived from the ratio of the overlapping length of the IJV to the horizontal diameter of the CCA measured on the ultrasonographic image.
The formula of calculation is as follows: overlap index = [overlap length (mm)/ CCA diameter (mm)] X 100(%), the measurements were repeated according to the degree of head rotation (neutral, 15 degree, 30 degree, 45 degree)
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at 5 min after anesthesia induction
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
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The success of simulated internal jugular vein puncture (central landmark)
時間枠:at 5 min after anesthesia induction
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The success of internal jugular vein puncture guided by the central landmark simulated on the ultrasonographic images, the measurements were repeated according to the degree of head rotation (neutral, 15 degree, 30 degree, 45 degree)
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at 5 min after anesthesia induction
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The success of simulated internal jugular vein puncture (external jugular vein landmark)
時間枠:at 5 min after anesthesia induction
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The success of internal jugular vein puncture as guided by 1.5 cm or 2.5 cm medial to the external jugular vein simulated on the ultrasonographic images, the measurements were repeated according to the degree of head rotation (neutral, 15 degrees, 30 degrees, 45 degrees)
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at 5 min after anesthesia induction
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協力者と研究者
スポンサー
研究記録日
主要日程の研究
研究開始
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (見積もり)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
キーワード
その他の研究ID番号
- 2011-04-024
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。
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