Effect of Head Rotation on Efficiency of Face Mask Ventilation in Anesthetized Apneic Adults

Study Overview
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Brief Summary
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Upper airway obstruction commonly occurs after induction of general anesthesia. The aim of this study is to determine if head rotation improves the efficiency of mask ventilation of anesthetized apneic adults.

Detailed Description
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When apnea is achieved after induction, face mask ventilation is started in either a neutral head position or a head position axially rotated 45 degrees to the right. Mask ventilation will be carried out for 1 minute (Step 1) with pressure control ventilation of an anesthesia machine at peak inspiratory pressure 15 cmH2O, 10 breaths per minute, inspiration time to expiration time ratio 1:2 and no positive end-expiratory pressure. Then, mask ventilation will continue but head position will be crossed over (Step 2) and Step 1 will be repeated (Step 3). Expiratory tidal volume (VTE) will be measured by using respiratory inductive plethysmograph.

Official Title
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Effect of Head Rotation on Efficiency of Face Mask Ventilation in Anesthetized Apneic Adults: A Prospective Randomized Crossover Study

Conditions
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Anesthesia

Intervention / Treatment
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* Procedure: Head rotation during mask ventilation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with body mass index in the range of 18.5 to 35.0 kg/m2, who meet American society of anesthesiologists physical status classification I to III and require general anesthesia with tracheal intubation. Exclusion Criteria: Patients with limited head rotation/extension, gastro-esophageal reflux or a full stomach, known sleep apnea in continuous positive airway pressure therapy and any anticipated difficult airway likely requiring awake intubation.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 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

Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mask ventilation in rotated head position<br>Patient's head will be axially rotated 45 degrees to the right | Procedure: Head rotation during mask ventilation<br>* Patient's head position is axially rotated 45 degrees to the right.<br>|
| No Intervention: Mask ventilation in neutral head position<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in averaged expiratory tidal volume measured by Respiratory monitor | Change in tidal volume between data of 2 min and average data from 1 and 3 min | 1, 2 and 3 min after the initiation of mask ventilation | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Airway, Anesthesia induction, Mask ventilation