A pilot study of upper airway management using a remote-controlled artificial muscle device during propofol anesthesia

Abstract Study objective To test the hypothesis that the jaw closure using a pneumatic actuator device affect airway collapsibility and resistance during propofol anesthesia. Design Prospective, randomized study. Setting University-affiliated hospital. Patients Six male subjects were included in the...

Full description

Saved in:
Bibliographic Details
Published in:Journal of clinical anesthesia 2016-03, Vol.29, p.75-82
Main Authors: Kurata, Shinji, DDS, PhD, Sanuki, Takurou, DDS, PhD, Okayasu, Ichiro, DDS, PhD, Kawai, Mari, DDS, PhD, Moromugi, Shunji, PhD, Ayuse, Takao, DDS, PhD
Format: Article
Language:English
Subjects:
Adult
Airway management
Airway Management - methods
Airway Obstruction - prevention & control
Airway Resistance
Anesthesia
Anesthesia & Perioperative Care
Anesthesia, Intravenous - methods
Anesthetics, Intravenous - administration & dosage
Compressed Air
Endoscopy
Head Movements - physiology
Humans
Jaw - physiology
Jaw closure
Male
Medical imaging
Pain Medicine
Pilot Projects
Pneumatic actuator
Positional change
Propofol - administration & dosage
Robotics - instrumentation
Robotics - methods
Sleep disorders
Upper airway patency
Young Adult
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Study objective To test the hypothesis that the jaw closure using a pneumatic actuator device affect airway collapsibility and resistance during propofol anesthesia. Design Prospective, randomized study. Setting University-affiliated hospital. Patients Six male subjects were included in the present study. Intervention We used pressure-flow relationships to evaluate critical closing pressure (PCRIT ) and upper airway resistance in different conditions of body and head position. Anesthesia was induced and maintained with a propofol infusion, targeting a constant blood concentration of 1.5 to 2.0 μg/mL to establish an adequate depth of anesthesia, with patients breathing spontaneously through a nasal mask. An air-inflatable pneumatic actuator was used to achieve jaw closure. Nasal mask pressure was intermittently reduced to evaluate upper airway collapsibility (passive PCRIT ) and upstream resistance under 4 different conditions: (1) neutral occlusion at 0-cm head elevation (baseline), (2) jaw closure at 0-cm head elevation, (3) neutral occlusion at 6-cm head elevation, and (4) jaw closure at 6-cm head elevation. PCRIT and upstream resistance under each condition were compared using 1-way analysis of variance. P < .05 was considered significant. Measurements The pressure and inspiratory flow at the subjects' nose mask were recorded. Polysomonographic parameters (electroencephalograms, electrooculograms, submental electromyograms, and plethysmogram) were also recorded. Main results The combination of 6-cm head elevation with jaw closure using the pneumatic actuator decreased upper airway collapsibility (PCRIT ≈ − 3.0 cm H2 O) compared to the baseline position (PCRIT ≈ − 1.2 cm H2 O; P = .0003). Conclusion We demonstrated that jaw closure using an air-inflatable pneumatic actuator device can produce substantial decreases in upper airway collapsibility and maintain upper airway patency during propofol anesthesia.
ISSN:0952-8180
1873-4529
DOI:10.1016/j.jclinane.2015.10.016