Clinical trial NCT05688722: Head Elevation During Pre-oxygenation Can Delay Desaturation Time
Official title: Head Elevation During Pre-oxygenation Can Delay Desaturation Time in Indonesian Patients
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Surgery
Desaturation of Blood
Apnea
Keywords: preoxygenation
head elevation
desaturation
apnea
Lead sponsor: Indonesia University
Sponsor class: OTHER
First posted: 2023-01-18
Enrollment: 56
Sex: ALL
Minimum age (years): 18
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Patients were divided into 4 groups by random sampling each with different intervention
Primary purpose: TREATMENT

Brief summary: This study is a randomized-controlled trial study comparing the association between several degree of head elevation and conventional position during pre-oxygenation to desaturation time in patients undergo endotracheal intubation with general anesthesia

Detailed description: Preoxygenation anesthesia induction is an important part of airway management to reduce the risk of hypoxemia when the patient is apneic. The effectivity of preoxygenation is influenced by several things such as patient's head position. This study aimed to compare preoxygenation with head elevation 20°, 30° and 45° and conventional position to the time of desaturation before endotracheal intubation in patients undergoing general anesthesia. This was a randomized clinical trial of 56 patients, divided into four groups (conventional or 0° head elevation group, 20° head elevation group, 30° head elevation and 45° head elevation group). All subject was preoxygenated for 3 minutes with 100% oxygen. Induction of anesthesia was started with fentanyl, propofol, followed by rocuronium after the patient lost consciousness. Time was recorded from the start of induction until the oxygen saturation showed 93% or a time limit of 5 minutes. There was a significant difference in mean desaturation time among the four groups (p = 0.011). The most significant different was in 45o head elevation group (p \< 0.05). . In patients undergoing general anesthesia, pre-oxygenation with head elevation 20°, 30° and 45° slows down the time for desaturation before endotracheal intubation compared to the conventional position. The 45° head elevation has the best result.

Eligibility criteria: Inclusion Criteria:

* undergo endotracheal intubation with general anesthesia for elective surgery
* aged 18-60 years old
* ASA physical status 1-2 preoperatively

Exclusion Criteria:

* Patients with difficult airway, cardiopulmonary disease, anemia, grade II obesity, pregnant, history of hypersensitivity to induction agents
* Patients did not give consent to follow the study

Primary outcomes:
measure: Desaturation time
timeFrame: Right after induction until reach oxygen saturation 93% or 5 minutes time limit
Secondary outcomes:
Other outcomes:
Locations:
city: Jakarta Pusat
country: Indonesia
facility: Cipto Mangunkusumo Central National Hospital
state: DKI Jakarta
Study officials:
affiliation: Indonesia University
name: Ratna F Soenarto, Consultant
role: PRINCIPAL_INVESTIGATOR
References: