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Comparing two airway management strategies for moderately sedated patients undergoing awake craniotomy: A single‐blinded randomized controlled trial

Authors :
Jin‐Song Wu
Ying-Wei Wang
Tao Zhang
Xiao-Bing Hu
Meng Deng
Yi-Heng Liu
Meng-Yun Tu
Source :
Acta Anaesthesiologica Scandinavica. 64:1414-1421
Publication Year :
2020
Publisher :
Wiley, 2020.

Abstract

BACKGROUND In the monitored anesthesia care (MAC) setting for awake craniotomy (AC), maintaining airway patency in sedated patients remains challenging. This randomized controlled trial aimed to compare the validity of the below-epiglottis transnasal tube insertion (the tip of the tube placed between the epiglottis and vocal cords) and the nasopharyngeal airway (simulated by the above-epiglottis transnasal tube with the tip of the tube placed between the epiglottis and the free edge of the soft palate) with respect to maintaining upper airway patency for moderately sedated patients undergoing AC. METHODS Sixty patients scheduled for elective AC were randomized to receive below-epiglottis (n = 30) or above-epiglottis (n = 30) transnasal tube insertion before surgery. Moderate sedation was maintained in the pre- and post-awake phases. The primary outcome was the upper airway obstruction (UAO) remission rate (relieved obstructions after tube insertion/the total number of obstructions before tube insertion). RESULTS The UAO remission rate was higher in the below-epiglottis group [100% (12/12) vs 45% (5/11); P = .005]. The tidal volume values monitored through the tube were greater in the below-epiglottis group during the pre-awake phase (P

Details

ISSN :
13996576 and 00015172
Volume :
64
Database :
OpenAIRE
Journal :
Acta Anaesthesiologica Scandinavica
Accession number :
edsair.doi.dedup.....224f60ddeb16a7970767b893877e7ab6
Full Text :
https://doi.org/10.1111/aas.13667