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Comparing two airway management strategies for moderately sedated patients undergoing awake craniotomy: A single‐blinded randomized controlled trial
- 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
- Subjects :
- Epiglottis
medicine.medical_treatment
Conscious Sedation
03 medical and health sciences
0302 clinical medicine
030202 anesthesiology
Intubation, Intratracheal
medicine
Humans
Intubation
Airway Management
Wakefulness
Craniotomy
Tidal volume
Soft palate
business.industry
medicine.medical_device
030208 emergency & critical care medicine
General Medicine
Airway obstruction
medicine.disease
Nasopharyngeal airway
Anesthesiology and Pain Medicine
medicine.anatomical_structure
Anesthesia
Airway management
business
Subjects
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