The Predictor of Respiratory Discomfort After the Shoulder Arthroscopic Surgery
Condition: Shoulder Arthroscopic Surgery
Study type: Observational

Summary: 
      The investigators applied upper airway ultrasonographic examination focusing the measurement
      of upper airway diameters in patients undergoing shoulder arthroscopic surgery to evaluate
      the change of upper airway anatomy before and after the surgery. The investigators also tried
      to find any findings of ultrasonographic examination that could reliably predict the dyspnea
      or airway compression after extubation. The investigators tried to compare the
      ultrasonographic findings with those of chest radiograph to validate the measurements of the
      ultrasonographic examination. A cuff leak test was preformed to evaluate its ability to
      predict the upper airway obstruction in shoulder arthroscopic surgery.
    

Detailed description: 
      During shoulder arthroscopic surgery, extravasation of irrigation fluid can occur around the
      shoulder and trachea, compressing the upper airway. Although the extravasation is generally
      reabsorbed asymptomatically within 12 hours, there are cases that lead to reintubation or
      life-threatening complications.

      An endotracheal tube is the most reliable method of securing the airway from airway
      obstruction during a shoulder arthroscopy surgery. However, since the airway may become
      obstructed after extubation, airway patency should be verified before extubation. Direct
      visualization of the larynx or trachea using laryngoscopy or bronchoscopy is difficult due to
      the presence of the tracheal tube. A cuff leak around the tracheal tube in a cuff-deflated
      condition is suggested to be a predictor of successful extubation. However, its reliability
      has been questioned in adult patients. A cuff leak could be affected by paratracheal
      pressure, which is thought to be elevated during shoulder arthroscopy. In a recent study, it
      was shown that laryngeal ultrasound can be a reliable, non-invasive method for the evaluation
      of laryngeal morphology or predicting post-extubation stridor.

      The investigators applied upper airway ultrasonographic examination focusing the measurement
      of upper airway diameters in patients undergoing shoulder arthroscopic surgery to evaluate
      the change of upper airway anatomy before and after the surgery. The investigators also tried
      to find any findings of ultrasonographic examination that could reliably predict the dyspnea
      or airway compression after extubation. The investigators tried to compare the
      ultrasonographic findings with those of chest radiograph to validate the measurements of the
      ultrasonographic examination. A cuff leak test was preformed to evaluate its ability to
      predict the upper airway obstruction in shoulder arthroscopic surgery.
    

Intervention name(s): upper airway ultrasonographic examination
Intervention type(s): Other
Intervention description(s): upper airway ultrasonographic examination and cuff leak test
Other intervention name(s): upper airway ultrasonographic examination ,; cuff leak test
Observational model: Case-Only
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        patients undergoing elective shoulder arthroscopic surgery (rotator cuff repair)
      
Keywords: shoulder arthroscopic surgery; dyspnea; airway diameter