caa a22 4500 445374616 CHVBK 20180317142959.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s00540-011-1098-3 doi (NATIONALLICENCE)springer-10.1007/s00540-011-1098-3 Preoxygenation with 20º head-up tilt provides longer duration of non-hypoxic apnea than conventional preoxygenation in non-obese healthy adults [Elektronische Daten] [Venkateswaran Ramkumar, Goneppanavar Umesh, Frenny Philip] Purpose: Failed airway is the anesthesiologist's nightmare. Although conventional preoxygenation can provide time, atelectasis occurs in the dependent areas of the lungs immediately after anesthetic 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 (group C) with 20º head-up tilt (group H) and 5cmH2O PEEP (group P) in non-obese individuals for non-hypoxic apnea duration. Methods: A total of 45 patients were enrolled (15 in each group). After 5min of preoxygenation, intubation was performed after induction of anesthesia with thiopentone and succinylcholine. After confirming the tracheal intubation by esophageal detector device and capnogram, all patients were administered vecuronium to maintain neuromuscular blockade and midazolam to prevent awareness. Post-induction, patients in all groups were left apneic in supine position with the tracheal tube exposed to atmosphere till the SpO2 dropped to 93% or 10min of safe apnea was achieved. Results: The demographic data were comparable. Non-hypoxic apnea duration was higher with group H (452±71s) compared to group C (364±83s, P = 0.030). Group P did not show significant increase in the duration of non-hypoxic apnea (413±86s). There were no adverse outcomes or events. Conclusions: Preoxygenation is clinically and statistically more efficacious and by inference more efficient in the 20º head-up position than with conventional technique in non-obese healthy adults. Although application of 5cmH2O PEEP provides longer duration of non-hypoxic apnea compared to conventional technique, it is not statistically significant. Japanese Society of Anesthesiologists, 2011 Preoxygenation nationallicence Apnea nationallicence PEEP nationallicence Head-up tilt nationallicence Ramkumar Venkateswaran Department of Anaesthesiology, Kasturba Medical College, 576104, Manipal, Karnataka, India aut Umesh Goneppanavar Department of Anaesthesiology, Kasturba Medical College, 576104, Manipal, Karnataka, India aut Philip Frenny Department of Anaesthesiology, Kasturba Medical College, 576104, Manipal, Karnataka, India aut Journal of Anesthesia Springer Japan 25/2(2011-04-01), 189-194 0913-8668 25:2<189 2011 25 540 https://doi.org/10.1007/s00540-011-1098-3 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-011-1098-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ramkumar Venkateswaran Department of Anaesthesiology, Kasturba Medical College, 576104, Manipal, Karnataka, India aut NATIONALLICENCE 700 1- Umesh Goneppanavar Department of Anaesthesiology, Kasturba Medical College, 576104, Manipal, Karnataka, India aut NATIONALLICENCE 700 1- Philip Frenny Department of Anaesthesiology, Kasturba Medical College, 576104, Manipal, Karnataka, India aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/2(2011-04-01), 189-194 0913-8668 25:2<189 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer