The purpose of this study is to investigate whether selected, short laryngologic surgical procedures can be safely and potentially more effectively performed without the use of endotracheal tube or jet ventilation, under completely tubeless conditions. The patient's gas exchange will be supported by rapid insufflation of high-flow oxygen through specialized nasal cannulae: the so called Transnasal Humidified Rapid- Insufflation Ventilatory Exchange (THRIVE).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
20
active nasal oxygen delivery system
a plastic tube for mechanical ventilation
Stanford Hospital and Clinics
Stanford, California, United States
Average Oxygen Saturation by Pulse Oximetry (SpO2) (Primary Anesthesia Outcome)
Time frame: intraoperative (up to one hour)
Time to Awakening From Anesthesia (Primary Anesthesia Outcome)
time from end of surgery to responding to commands/extubation
Time frame: intraoperative (up to 20 min)
Suspension Time (Primary Surgical Outcome)
Time required for the surgeon to position the patient's head and expose the surgical field for surgery using operating laryngoscope
Time frame: intraoperative (up to 5 min)
Number of Suspension Repositioning Maneuvers (Primary Surgical Outcome)
Number of attempts required for the surgeon to reposition the patient's head for optimal surgical exposure using operating laryngoscope
Time frame: intraoperative (up to 5 min)
Duration of Surgery (Primary Surgical Outcome)
Time frame: intraoperative (up to one hour)
Alertness
Time required for the patient to become fully alert and oriented per standard recovery room evaluation
Time frame: Recovery room admission (up to 30 min following admission to recovery room)
Recovery Room Time
Time frame: Up to 2 hours after procedure
Numerical Pain Rating Scores
A score from 0 to 10, higher scores corresponding to higher pain
Time frame: Recovery room admission and discharge (up to 2 hours)
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Opioid Consumption
Total oral opioid consumption in morphine milligram equivalents
Time frame: Recovery room admission and discharge (up to 2 hours)
Change in Voice Handicap Index (VHI)
numerical scale, range from 0 to 40, with higher scores corresponding to worse outcome
Time frame: Preoperative assessment and one month after surgery
Quality of Recovery
15-question survey, with each question scored from 0 to 10. Overall range 0-150, higher scores correspond to better outcome.
Time frame: One week after surgery