Cerebral Regional Oxygenation With Manual Versus AutoFlow Ventilation

Study Overview
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Brief Summary
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Anesthesia induction is associated with hemodynamic imbalances that can affect the blood flow to major organs. Moreover it can result in deoxygenation as well. During standard anesthesia induction the patient is manually ventilated with a circle-valve-mask system until the effect of muscle relaxant shows of. Near-infrared spectroscopy (NIRS) is a modification of a well-known peripheral pulse oxymetry that is used in the detection of the regional oxygen saturation (rSO2) in organs, including brain, liver, muscle, and intestines. In this study we will compare the regional oxygenation status of the patients during anesthesia induction in which either standard manual ventilation or mechanical ventilator-assisted ventilation was performed. AutoFlow(R) mode of Draeger-Perseus mechanical ventilator will be used for the ventilator-assisted ventilation.

Official Title
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Cerebral Regional Oxygenation With Manual Versus Mechanical Ventilator Assisted Ventilation During Intravenous Induction in Pediatric Patients

Conditions
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Oxygen Deficiency

Intervention / Treatment
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* Behavioral: Mechanical ventilator-assisted ventilation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: American Society of Anaesthesiologists (ASA) physical status I-II Exclusion Criteria: ASA III or above Congenital or traumatic brain injury Allergy to NIRS probe material Cardiac or vascular disease, including heart failure or hypertension Difficult mask ventilation and difficult intubation Thoracic surgery Head and neck surgery Emergency surgery Obesity

Ages Eligible for Study
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Minimum Age: 5 Years
Maximum Age: 10 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Group M<br>Manual ventilation | |
| Group A<br>AutoFlow mechanical ventilation | Behavioral: Mechanical ventilator-assisted ventilation<br>* After the intravenous anesthesia induction, mechanical ventilator-assisted ventilation with AutoFlow mode of the anesthesia machine (Draeger-Perseus) will be applied before intubation.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| NIRS_-1 | Serebral oxygenation status measured by near-infrared spectroscopy device (INVOS oximeter, Somanetics, Troy, MI, USA). | 60 seconds before induction. | 
| NIRS_0 | Serebral oxygenation status measured by near-infrared spectroscopy device (INVOS oximeter, Somanetics, Troy, MI, USA). | At the start of anesthesia induction. | 
| NIRS_0.5 | Serebral oxygenation status measured by near-infrared spectroscopy device (INVOS oximeter, Somanetics, Troy, MI, USA). | 30 seconds after the anesthesia induction. | 
| NIRS_1 | Serebral oxygenation status measured by near-infrared spectroscopy device (INVOS oximeter, Somanetics, Troy, MI, USA). | 60 seconds after the anesthesia induction. | 
| NIRS_1.5 | Serebral oxygenation status measured by near-infrared spectroscopy device (INVOS oximeter, Somanetics, Troy, MI, USA). | 90 seconds after the anesthesia induction. | 
| NIRS_2 | Serebral oxygenation status measured by near-infrared spectroscopy device (INVOS oximeter, Somanetics, Troy, MI, USA). | 120 seconds after the anesthesia induction. |