Safe Use of CPAP and PEEP During Induction of General Anesthesia

Study Overview
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Brief Summary
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The study compares the safety of using pressure controlled ventilation with a positive end-expiratory pressure (PEEP) during induction of general anaesthesia immediately after apnoea to a standard method starting ventilation manually without PEEP immediately after apnoea.

Detailed Description
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Using a continuous positive pressure (CPAP) during preoxygenation, followed by pressure controlled ventilation with PEEP after apnoea during induction of general anesthesia, might offer several benefits but safety issues needs more investigation. This study compares the safety of using pressure controlled with PEEP during induction of general anesthesia immediately after apnoea to a standard method starting ventilation manually without PEEP immediately after apnoea.

Official Title
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Safe Use of CPAP During Preoxygenation and PEEP After Apnoea During Induction of General Anesthesia

Conditions
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General Anesthesia

Intervention / Treatment
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* Procedure: Pressure controlled ventilation with PEEP
* Procedure: Manual ventilation without PEEP


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Normal or overweight patients scheduled for day case surgery in general anesthesia. American Society of Anesthesiologists functional class I-III. Body Mass Index 18.5-30. Exclusion Criteria: Increased risk of regurgitation of gastric content. Symptomatic asthma, COPD or heart failure. Peripheral oxygen saturation (SpO2) breathing air <94 % Anticipated difficult airway. Beard. Anatomical features making it difficult to keep a tight seal during maskventilation.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Pressure controlled ventilation with PEEP<br>In this group, ventilation after apnoea during induction of general anesthesia starts with pressure controlled ventilation with PEEP. | Procedure: Pressure controlled ventilation with PEEP<br>* The intervention consists of starting ventilation after apnoea during induction of general anesthesia with pressure controlled ventilation with PEEP instead of manually without PEEP.<br>|
| Active Comparator: Manual ventilation without PEEP<br>In this group, ventilation after apnoea during induction of general anesthesia starts with manual ventilation without PEEP. | Procedure: Manual ventilation without PEEP<br>* The intervention consists of starting ventilation after apnoea during induction of general anesthesia manually instead of with pressure controlled ventilation with PEEP.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of breaths until return of CO2. | When starting ventilation after apnea the number of breaths given until the return of CO2 is at least 1.3 kPa at a respiratory frequency of 10 per minute. | 2 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Positive end-expiratory pressure, Mechanical ventilation, Induction of anesthesia