PSV on Ventilation Inhomogeneity and Lung Function in Patients Under SB Across LMA

NCT ID: NCT02986269

Last Updated: 2022-02-28

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-04-13

Study Completion Date

2021-09-16

Brief Summary

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General anesthesia has been demonstrated to have a negative impact on lung function. Both surgery and patient position influence the perioperative lung function. Laryngeal mask airway (LMA) has been proved to be safe and efficient to maintain the airways patent during general anesthesia. Pressure support ventilation (PSV) with LMA is routinely used in clinical practice. The aim of the present trial is to characterize perioperative changes in lung volume, ventilation inhomogeneity and respiratory mechanics in patients in the lithotomy position and spontaneously breathing through LMA with and without PSV.

Detailed Description

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This study is a randomized controlled trial. Participants for this study will be recruited from the Gynecological department of the University Hospitals of Geneva, scheduled for gynecological procedures in the lithotomy position under general anesthesia. A total of 40 patients will be enrolled and randomly assigned into 2 groups: Group SB (spontaneously breathing without PSV) and Group PSV (spontaneously breathing with PSV). Measurements of end-expiratory lung volume (EELV) and ventilation inhomogeneity will be performed in all patients with a nitrogen multiple breath washout method, before and 1 hour after surgery. Similarly, airway resistance (Rrs) and reactance (Xrs) will be measured at the same time by using the Forced Oscillation Technique.

The primary endpoint: Perioperative changes in ventilation inhomogeneity (LCI) and respiratory mechanics (Rrs and Xrs) of patients, positioned in lithotomy and undergoing general anesthesia while breathing spontaneously through LMA with or without PSV.

The secondary endpoints: Presence of respiratory complications, oxygen need in the recovery room, length of stay in the recovery room and in the hospital. Correlation between duration of positioning and surgery with lung function and volume measurements.

Relevance: There are no studies that addressed the value of pressure support ventilation to overcome the potential changes in lung function following spontaneous ventilation across a LMA in the lithotomy position.

Conditions

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Respiratory Function Tests Anesthesia, General Patient Positioning Ventilation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Group SB

Patient is scheduled for elective conisation or hysteroscopy under general anesthesia. The ventilation mode for this group is spontaneous breathing(SB) without pressure support ventilation (PSV) under laryngeal mask airway (LMA).

General anesthesia across LMA under SB without PSV

Group Type EXPERIMENTAL

general anesthesia across LMA

Intervention Type PROCEDURE

general anesthesia across LMA

Spontaneous breathing(SB)

Intervention Type PROCEDURE

general anesthesia across LMA under SB without PSV

Group PSV

General anesthesia across LMA under SB with PSV Patient is scheduled for elective conisation or hysteroscopy under general anesthesia. The ventilation mode for this group is SB with PSV under LMA.

Group Type ACTIVE_COMPARATOR

general anesthesia across LMA

Intervention Type PROCEDURE

general anesthesia across LMA

Spontaneous breathing(SB)

Intervention Type PROCEDURE

general anesthesia across LMA under SB without PSV

Pressure Support Ventilation

Intervention Type PROCEDURE

general anesthesia across LMA under SB with PSV

Interventions

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general anesthesia across LMA

general anesthesia across LMA

Intervention Type PROCEDURE

Spontaneous breathing(SB)

general anesthesia across LMA under SB without PSV

Intervention Type PROCEDURE

Pressure Support Ventilation

general anesthesia across LMA under SB with PSV

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

\- American Society of Anesthesiologists physical status (ASA) Ⅰ and Ⅱ grade, adult female patients, aged between 18 and 50 years scheduled for elective gynecological surgery in the lithotomy position.

Exclusion Criteria

1. Age\<18 years and \>50 years old
2. ASA score of III-V
3. Patients with a potentially difficult airway (cervical spine disease, Mallampati classification III or IV or mouth opening of \<2.5 cm)
4. Risk of regurgitation/aspiration(previous upper gastrointestinal tract surgery, known or symptomatic hiatus hernia, oesophageal reflux, peptic ulceration or not fasted)
5. Respiratory diseases(bronchial asthma requiring therapy)
6. Patient refusal
7. Malignant hyperthermia history
8. Sore throat within 10 days
9. Body mass index (BMI) \>30 kg/m2
10. Cardiac disease associated with dyspnea more than New York Heart Association II
11. Severe psychiatric disorder.
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Walid HABRE

OTHER

Sponsor Role lead

Responsible Party

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Walid HABRE

Anesthesiology

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Walid HABRE, MD,PhD

Role: PRINCIPAL_INVESTIGATOR

University Hospitals of Geneva

Locations

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University Hospitals of Geneva

Geneva, , Switzerland

Site Status

Countries

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Switzerland

References

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Sudy R, Dereu D, Lin N, Pichon I, Petak F, Habre W, Albu G. Respiratory effects of pressure support ventilation in spontaneously breathing patients under anaesthesia: Randomised controlled trial. Acta Anaesthesiol Scand. 2024 Mar;68(3):311-320. doi: 10.1111/aas.14350. Epub 2023 Nov 3.

Reference Type DERIVED
PMID: 37923301 (View on PubMed)

Other Identifiers

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VINHO

Identifier Type: -

Identifier Source: org_study_id

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