- 期刊
The Jaw Elevation Device (JED) Versus Nasopharyngeal Airway for Prevention of Upper Airway Obstruction Under Target-Controlled Infusion Anesthesia
摘要
Patients undergoing invasive examination or therapeutic intervention often require sedation and analgesia, and total intravenous anesthesia with target-controlled infusion (TCI) has become a popular option for this purpose. However, upper airway obstruction is a potentially fatal complication of anesthesia. The Jaw Elevation Device (JED, HYPNOZ Therapeutic Devices) is a new instrument designed to maintain the airway. This study compared the efficacy of the JED with the nasopharyngeal airway (NPA) device for the prevention of upper airway obstruction under TCI anesthesia. Fifty-four patients were randomly allocated to three groups of 18: JED, NPA, and no intervention (standard) groups. Anesthesia was induced by lidocaine, fentanyl, and propofol with TCI (Schnider model). We measured the tidal volume (Vt) via a well-sealed facemask before induction (pre-anesthetic Vt) and after the assigned intervention under a steady-state effect-site concentration (anesthetic Vt). The efficacy in terms of prevention of upper airway obstruction (primary outcome) was assessed by measuring the change in tidal volume per kilogram (ΔVt/kg; ΔVt = pre-anesthetic Vt- anesthetic Vt), lower values indicating superior airway patency maintenance. The change in tidal volume per kilogram (ΔVt/kg) (median [interquartile range]) was significantly lower in the JED group (2.85 [2.2-4.26]) than in both the NPA group (5.25 [3.15-6.43]; p = 0.027) and the standard group (5.31 [4.34-6.27]; p ＜ 0.001). The secondary outcomes (need for airway intervention due to airway problems or device-related complications) did not differ significantly between groups. The JED demonstrated a better efficacy for the prevention of upper airway obstruction than the NPA device under TCI anesthesia.
延伸閱讀
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