Efficacy of Apnoeic Oxygenation by Nasal Prongs in Preventing Desaturation during Airway Management in Infants Undergoing General Anaesthesia: A Randomised Controlled Study
Introduction: Neonates and infants are more prone to desaturation during the apnoeic period of laryngoscopy and intubation. Various options exist to reduce this risk beyond conventional preoxygenation. Aim: To assess whether continuous apnoeic oxygenation via nasal prongs during intubation can...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2023-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/18381/65714_CE[Ra1]_F(KR)_QC(KK_OM)_PF1(RI_SS)_PFA(RI_KM)_PN(KM).pdf |
| Summary: | Introduction: Neonates and infants are more prone to
desaturation during the apnoeic period of laryngoscopy and
intubation. Various options exist to reduce this risk beyond
conventional preoxygenation.
Aim: To assess whether continuous apnoeic oxygenation via
nasal prongs during intubation can extend the safe apnoea period
compared to standard management with preoxygenation alone.
Materials and Methods: A randomised controlled, two-group
parallel clinical study was conducted at the Department of
Anaesthesiology, Vijayanagar Institute of Medical Sciences,
Ballari, Karnataka, India, from July 2019 to November 2020. The
study involved 63 infants aged one day to six months undergoing
elective or emergency surgeries under general anaesthesia.
Preoxygenation via a mask was followed by sevoflurane induction
and vecuronium-induced muscle relaxation. Conventional
laryngoscopy and intubation were performed in 32 infants in
Group-C (Control group), while 31 infants in Group-O (Apnoeic
Oxygenation group) also received oxygen (O2
) via nasal prongs at
4 L/min in addition to preoxygenation.
The primary outcome parameter was the time taken for
desaturation by 1%. The time taken to desaturate by 2%, 3%,
4%, and 5%, as well as their incidences, lowest observed
saturation, safe apnoea period, and Heart Rate (HR) trends,
were also noted. Data were analysed using Statistical Package
for Social Sciences (SPSS) version 20.0 and OpenEpi version
3.01.
Results: Demographic and clinical parameters were comparable
between the groups. The mean time for 1% desaturation
was 18.33±4.3 seconds in Group-C, while all Group-O cases
maintained 100% saturation during the study period. No
significant difference was found in the safe apnoea period
between the groups (p=0.503). The average lowest O2
saturation
observed in Group-C was 98.81±1.28%, while it was 100% in
Group-O. Only one infant in Group-C showed desaturation down
to 95%. Both groups exhibited similar HR trends.
Conclusion: Apnoeic oxygenation by nasal prongs in healthy
infants helps prolong the time to desaturation and can be
beneficial for those at risk of desaturation and hypoxia. |
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| ISSN: | 2249-782X 0973-709X |