Changes in the upper airway following induction of anaesthesia: a prospective observational study protocol to determine the use of ultrasound in the assessment of a difficult airway in China
Changes in the upper airway following induction of anaesthesia: a prospective observational study protocol to determine the use of ultrasound in the assessment of a difficult airway in China
复制标题
麻醉诱导后上呼吸道的变化：一项前瞻性观察研究方案，以确定超声在中国困难气道评估中的应用
DOI：
10.1136/bmjopen-2019-029782
复制
发表时间：
2019-08-01
期刊：
影响因子：
2.9
通讯作者：
Ma, Wuhua
中科院分区：
文献类型：
--
作者：
Dong, Fang;Wang, Yong;Ma, Wuhua
前言困难气道的管理与医疗护理的安全和质量密切相关。然而，在临床筛选试验中，困难气道的正确预测率低，这给医生带来了困境。睡眠和麻醉期间气道神经肌肉张力降低往往会导致上气道脆弱部分塌陷。尽管先前的研究已经证实颈前组织厚度与困难气道相关，但没有证据支持困难气道与麻醉诱导的气道塌陷的特定模式或结果之间的相关性。因此，本研究旨在检查全麻诱导前后气道尺寸的变化，以探讨是否可以提供有关可能导致困难气道的特定解剖变化的有用信息。方法和分析这将是一项单中心前瞻性观察性单盲研究，在中国广州的一家三级教学医院进行。受试者将从计划在全身麻醉下进行择期手术的患者（年龄18-65岁）中招募。将进行超声测量，以检测麻醉诱导前后颈椎前路软组织厚度的变化。根据所得数据分布，分析将首先使用配对t检验或Wilcoxon符号秩检验比较这些变化。将使用受试者工作特征曲线评价超声改变与Cormack-Lehane分级的相关性，以检测检测困难测量的灵敏度和特异性。将使用线性逐步回归分析来评估气道变化与人口统计学变量以及临床测试之间的相关性。伦理与传播已获得广州中医药大学第一附属医院伦理委员会的伦理批件（中医科（2018）041号）。研究结果将通过会议介绍、专业期刊和同行评审出版物传播。试验注册号ChiCTR 1900021123;预结果。
Introduction Difficult airway management is closely related to the safety and quality of medical care. However, the low incidence of correct prediction of difficult airway in clinical screening tests presents physicians with a dilemma. Depressed airway neuromuscular tension during sleep and anaesthesia tends to cause collapse of fragile parts of the upper airway. Although previous studies have confirmed that anterior cervical tissue thickness is associated with difficult airways, there is no evidence to support a correlation between a difficult airway and specific patterns or findings of anaesthesia-induced airway collapse. Thus, this study aims to examine changes in airway dimensions before and after induction of general anaesthesia to explore whether it could provide useful information regarding the specific anatomic changes occurring which may cause difficult airways. Methods and analysis This will be a single-centre prospective observational single-blinded study, conducted in a tertiary teaching hospital in Guangzhou, China. Subjects will be recruited from patients (aged 18–65 years) scheduled for elective surgery under general anaesthesia. Sonographic measurement will be performed to detect changes in the thickness of the anterior cervical soft tissue before and after anaesthetic induction. Based on the resulting data distribution, analyses will initially compare these changes using a paired t-test or the Wilcoxon signed-rank test. The correlation of sonographic changes and Cormack–Lehane grade will be evaluated by using receiver-operating characteristic curves to detect the sensitivity and specificity of a measurement for detecting difficulties. Linear stepwise regression analysis will be used to assess the correlation between airway changes and demographic variables as well as clinical tests. Ethics and dissemination Ethical approval has been obtained from the Ethics Committee of the First Affiliated Hospital of Guangzhou University of Chinese Medicine (ZYYECK (2018) 041). The results will be disseminated through conference presentations, professional journals and peer-reviewed publications. Trial registration number ChiCTR1900021123; Pre-results.