NCT03239236

Brief Summary

This study investigates the effect of 4 different methods of rapid sequence induction (RSI) in morbidly obese patients on the amount of air insufflation into the stomach.

Trial Health

30
At Risk

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Trial has exceeded expected completion date
Timeline
Completed

Started Feb 2021

Geographic Reach
1 country

1 active site

Status
withdrawn

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

June 16, 2017

Completed
2 months until next milestone

First Posted

Study publicly available on registry

August 4, 2017

Completed
3.5 years until next milestone

Study Start

First participant enrolled

February 1, 2021

Completed
Same day until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 1, 2021

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

February 1, 2021

Completed
Last Updated

February 18, 2021

Status Verified

February 1, 2021

Enrollment Period

Same day

First QC Date

June 16, 2017

Last Update Submit

February 16, 2021

Conditions

Outcome Measures

Primary Outcomes (1)

  • Amount of air aspirated with a gastric tube

    The amount of air that can be aspirated via a nasogastric tube at the beginning of laparoscopy. A nasogastric tube will be inserted at the beginning of laparoscopy and the air from the stomach will be aspirated with a syringe. The amount of air will be measured in ml.

    at the beginning of the laparoscopy

Secondary Outcomes (2)

  • Gastric inflation

    at the beginning of laparoscopy

  • partial pressure of oxygen in arterial blood (paO2)

    before pre oxygenation, before anesthesia induction, before laryngoscopy, immediately after intubation when the cuff of the tracheal tube is inflated

Study Arms (4)

t-RSI

EXPERIMENTAL

Rapid sequence induction t-RSI. Traditional rapid sequence induction with Anesthetics. Preoxygenation via face mask, no ventilation with no PEEP until intubation. Aspiration of gastric air via nasogastric tube at the beginning of laparoscopy. Impression of gastric inflation at laparoscopy will be assessed by taking images of the stomach at the beginning of laparoscopy. Arterial blood gas samples will be taken at different time points.

Procedure: Rapid sequence induction t-RSIDrug: AnestheticsDiagnostic Test: Aspiration of gastric air via nasogastric tubeDiagnostic Test: Impression of gastric inflation at laparoscopy.Diagnostic Test: Arterial blood gas

m-RSI-PEEP

EXPERIMENTAL

Rapid sequence induction m-RSI-PEEP. Modified rapid sequence induction with Anesthetics and PEEP. Preoxygenation via facemask with PEEP of 10 mbar. PEEP will be continued until intubation. Aspiration of gastric air via nasogastric tube at the beginning of laparoscopy. Impression of gastric inflation at laparoscopy will be assessed by taking images of the stomach at the beginning of laparoscopy. Arterial blood gas samples will be taken at different time points.

Procedure: Rapid sequence induction m-RSI-PEEPDrug: AnestheticsDiagnostic Test: Aspiration of gastric air via nasogastric tubeDiagnostic Test: Impression of gastric inflation at laparoscopy.Diagnostic Test: Arterial blood gas

m-RSI-vent

EXPERIMENTAL

Rapid sequence induction m-RSI-vent. Modified rapid sequence induction with Anesthetics and intermittent ventilation. Preoxygenation via facemask with 10 mbar PEEP and 8 mbar pressure support. Backup frequency set at 10/min. Ventilation via anesthetic machine until intubation. Aspiration of gastric air via nasogastric tube at the beginning of laparoscopy. Impression of gastric inflation at laparoscopy will be assessed by taking images of the stomach at the beginning of laparoscopy. Arterial blood gas samples will be taken at different time points.

Procedure: Rapid sequence induction m-RSI-ventDrug: AnestheticsDiagnostic Test: Aspiration of gastric air via nasogastric tubeDiagnostic Test: Impression of gastric inflation at laparoscopy.Diagnostic Test: Arterial blood gas

m-RSI-vent-cric

EXPERIMENTAL

Rapid sequence induction m-RSI-vent-cric. Modified rapid sequence induction with Anesthetics and intermittent ventilation and cricoid pressure. Same as "modified rapid sequence induction with intermittent ventilation" arm with additional cricoid pressure. Aspiration of gastric air via nasogastric tube at the beginning of laparoscopy. Impression of gastric inflation at laparoscopy will be assessed by taking images of the stomach at the beginning of laparoscopy. Arterial blood gas samples will be taken at different time points.

Procedure: m-RSI-vent-cricProcedure: Cricoid PressureDrug: AnestheticsDiagnostic Test: Aspiration of gastric air via nasogastric tubeDiagnostic Test: Impression of gastric inflation at laparoscopy.Diagnostic Test: Arterial blood gas

Interventions

Preoxygenation via face mask, no ventilation with no PEEP until intubation

t-RSI

Preoxygenation via facemask with PEEP of 10 mbar. PEEP will be continued until intubation.

m-RSI-PEEP

Preoxygenation via facemask with 10 mbar PEEP and 8 mbar pressure support. Backup frequency set at 10/min. Ventilation via anesthetic machine until intubation.

m-RSI-vent

Preoxygenation via facemask with 10 mbar PEEP and 8 mbar pressure support. Backup frequency set at 10/min. Ventilation via anesthetic machine until intubation.

m-RSI-vent-cric

Cricoid Pressure will be applied during RSI until laryngoscopy

m-RSI-vent-cric

Induction agents will be administered as quick boluses (Propofol 2,5mg/kg total body weight, max 350mg, Fentanyl 250mcg, Rocuronium 1,2mg/kg ideal body weight).

Also known as: Induction Agents
m-RSI-PEEPm-RSI-ventm-RSI-vent-crict-RSI

A nasogastric tube will be inserted at the beginning of laparoscopy and the air from the stomach will be aspirated with a syringe. The amount of air will be measured in ml.

m-RSI-PEEPm-RSI-ventm-RSI-vent-crict-RSI

The impression of gastric inflation at laparoscopy. At the beginning of laparoscopy, images of the stomach will be recorded.

m-RSI-PEEPm-RSI-ventm-RSI-vent-crict-RSI
Arterial blood gasDIAGNOSTIC_TEST

Arterial blood gases will we drawn at different time points to investigate oxygenation during the procedure. Blood gases will be taken before pre-oxygenation, before anesthesia induction, before laryngoscopy, immediately after intubation when the cuff of the tracheal tube is inflated.

m-RSI-PEEPm-RSI-ventm-RSI-vent-crict-RSI

Eligibility Criteria

Age19 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • BMI \> 40
  • American Society of Anesthesiology Class 1-3
  • Elective laparoscopic surgery

You may not qualify if:

  • Pregnant or breastfeeding patients
  • Previous bariatric surgery
  • Anticipated difficult airway

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Medical University of Vienna

Vienna, 1090, Austria

Location

MeSH Terms

Interventions

AnestheticsBlood Gas Analysis

Intervention Hierarchy (Ancestors)

Central Nervous System DepressantsPhysiological Effects of DrugsPharmacologic ActionsChemical Actions and UsesCentral Nervous System AgentsTherapeutic UsesBlood Chemical AnalysisClinical Chemistry TestsClinical Laboratory TechniquesDiagnostic Techniques and ProceduresDiagnosisRespiratory Function TestsDiagnostic Techniques, Respiratory SystemInvestigative Techniques

Study Officials

  • Walter Plöchl, Professor

    Medical University of Vienna

    PRINCIPAL INVESTIGATOR
0

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
INVESTIGATOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Univ. Prof. Dr.

Study Record Dates

First Submitted

June 16, 2017

First Posted

August 4, 2017

Study Start

February 1, 2021

Primary Completion

February 1, 2021

Study Completion

February 1, 2021

Last Updated

February 18, 2021

Record last verified: 2021-02

Locations