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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.
Studie Overzicht
Toestand
Interventie / Behandeling
Gedetailleerde beschrijving
Studietype
Inschrijving (Werkelijk)
Contacten en locaties
Studie Locaties
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Seoul, Korea, republiek van, 135-710
- Samsung Medical Center
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Bemonsteringsmethode
Studie Bevolking
Beschrijving
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
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
Interventie / Behandeling |
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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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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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overlap index
Tijdsspanne: 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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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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The success of simulated internal jugular vein puncture (central landmark)
Tijdsspanne: 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)
Tijdsspanne: 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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Medewerkers en onderzoekers
Sponsor
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Andere studie-ID-nummers
- 2011-04-024
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