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Comparison of preoxygenation in supine position versus 150 head up tilt to look for duration of non-hypoxic apnoea in non-obese healthy adults

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Original Article

Author Details : Yoganarasimha N, Shashank MR, Raghavendra TR, Radha MK

Volume : 3, Issue : 4, Year : 2016

Article Page : 631-634

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Abstract

Purpose: Preoxygenation increases oxygen reserves and duration of apnoea without desaturation (DAWD), thus it provides valuable additional time to secure the airway. Although conventional preoxygenation can provide time, atelectasis occurs in the dependent areas of the lungs immediately after anaesthetic induction. Therefore, alternatives such as positive end-expiratory pressure (PEEP) and head-up tilt during preoxygenation have been explored.  We compared the conventional preoxygenation technique in Group I with 15⁰ head up tilt in Group II in non-obese individuals for non-hypoxic apnoea duration.
Materials & Methods: Sixty patients scheduled for various elective surgical procedures belonging to ASA Grade I and ASA Grade II were included in study. The study was designed to be a double blind randomized controlled study. Anaesthesia was induced with Inj. Thiopentone 5mg/kg IV till the loss of eyelash reflex. Adequacy of mask ventilation was confirmed. Inj. Rocuronium 0.9mg/kg IV was given. The patient was disconnected from the breathing system. The duration of apnoea was recorded as from the time of administration of rocuronium to the time the SpO₂ falls to <95% as measured by pulse oximetry, when at this point the patient was be reconnected to the breathing system and mask ventilation was commenced with 100% inspired oxygen, then intubated, and proceed with proposed surgery. Results: The demographic data were comparable. Non-hypoxic apnoea duration was higher with group II 423.1±51.71s compared to group I 284±29.51 seconds (P = <0.0001). There were no adverse outcomes or events.
Conclusion: Preoxygenation is clinically and statistically more efficacious and by inference more efficient in the 15º head-up position than with conventional technique in non-obese healthy adults.

Keywords: Preoxygenation, Apnoea, Supine, Head-up tilt, DAWD (Duration of Apnoea without Desaturation)

How to cite : Yoganarasimha N, Shashank Mr, Raghavendra Tr, Radha Mk, Comparison of preoxygenation in supine position versus 150 head up tilt to look for duration of non-hypoxic apnoea in non-obese healthy adults. Indian J Clin Anaesth 2016;3(4):631-634

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