Fraction of Oxygen on Induction of Anesthesia in Infants

Study Overview
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Brief Summary
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Invesetigators evaluated the effect of positive end-expiratory pressure during anaesthesia induction on nonhypoxic apnoea time in infants. Invesetigators assigned infants to a 7 cmH2O positive end expiratory pressure (PEEP) with fraction of inspired oxygen 80% or 0 cmH2O PEEP with fraction of oxygen 80% group. Anaesthesia was induced with 0.02 mg kg atropine, 5 mg kg thiopental sodium and 3 to 5% sevoflurane, and neuromuscular blockade with 0.6 mg kg rocuronium. Thereafter, 80% oxygen was provided via face mask with volume-controlled ventilation of 6 ml kg tidal volume, and either 7 cmH2O or no positive end-expiratory pressure. After 3 min of ventilation, the infants' trachea was intubated but disconnected from the breathing circuit, and ventilation resumed when pulse oximetry reached 95%.

Official Title
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The Effect of Positive End-expiratory Pressure During Induction of General Anesthesia and Non-hypoxic Apnea Time in Infants: a Randomized Controlled Trials

Conditions
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Apnea

Intervention / Treatment
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* Other: positive end expiratory pressure
* Other: fraction of inspired oxygen 80%


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: We included paediatric patients aged 12 months or less about to receive general anaesthesia with endotracheal intubation. Exclusion Criteria: Neonates, former preterm infants with gestational age less than 60 weeks at the day of surgery, with previous history of respiratory disease, those with anticipated difficult mask ventilation or intubation and those with upper respiratory infection within 3 weeks were excluded.

Ages Eligible for Study
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Minimum Age: 1 Month
Maximum Age: 12 Months

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 |
| --- | --- |
| Active Comparator: fraction of inspired oxygen 80%<br> | Other: fraction of inspired oxygen 80%<br>* fraction of inspired oxygen 80% applied during induction of anesthesia<br>|
| Experimental: Fraction of inspired oxygen 80% with positive end expiratory pressure<br> | Other: positive end expiratory pressure<br>* 7cmH2O of positive end expiratory pressure with fraction of inspired oxygen 80% applied during induction of anesthesia<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| apnea time | The primary outcome was nonhypoxic apnoea time defined as the time from cessation of ventilation to a pulse oximeter reading of 95% | during face mask ventilation, maximum 3 minutes. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| atelectasis score (0 72) | atelectasis score assessed by lung ultrasound (0-72) | during anesthesia induction, maximum 5 minutes. | 
| Number of participants with gastric air insufflation | presence of air in the gastric antrum | during anesthesia induction, maximum 5 minutes. |