Fraction of Oxygen on Induction of Anesthesia in Infants

Seoul National University Hospital84 enrolled

Overview

Invesetigators evaluated the effect of positive end-expiratory pressure during anaesthesia induction on nonhypoxic apnoea time in infants. Invesetigators assigned infants to a 7 cmH2O positive end expiratory pressure (PEEP) with fraction of inspired oxygen 80% or 0 cmH2O PEEP with fraction of oxygen 80% group. Anaesthesia was induced with 0.02 mg kg atropine, 5 mg kg thiopental sodium and 3 to 5% sevoflurane, and neuromuscular blockade with 0.6 mg kg rocuronium. Thereafter, 80% oxygen was provided via face mask with volume-controlled ventilation of 6 ml kg tidal volume, and either 7 cmH2O or no positive end-expiratory pressure. After 3 min of ventilation, the infants' trachea was intubated but disconnected from the breathing circuit, and ventilation resumed when pulse oximetry reached 95%.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Enrollment

Conditions

Apnea

Interventions

Eligibility

Sex: ALLMin age: 1 MonthMax age: 12 Months

Medical Language ↔ Plain English

Inclusion Criteria: * We included paediatric patients aged 12 months or less about to receive general anaesthesia with endotracheal intubation. Exclusion Criteria: * Neonates, former preterm infants with gestational age less than 60 weeks at the day of surgery, with previous history of respiratory disease, those with anticipated difficult mask ventilation or intubation and those with upper respiratory infection within 3 weeks were excluded.

Outcomes

Primary Outcomes

apnea time

The primary outcome was nonhypoxic apnoea time defined as the time from cessation of ventilation to a pulse oximeter reading of 95%

Time frame: during face mask ventilation, maximum 3 minutes.

Secondary Outcomes

atelectasis score (0~72)

atelectasis score assessed by lung ultrasound (0-72)

Time frame: during anesthesia induction, maximum 5 minutes.

Number of participants with gastric air insufflation

presence of air in the gastric antrum