Multi-Strategy Intervention for Anesthesia Care of Obese Patients A Factorial Randomized Controlled Trial

• Status: Recruiting
• Trial end date: 2023-08-01
• Target enrollment: 0
• Participant gender: All

Summary

The main objective of this study is to investigate the optimal anesthesia for obese patients undergoing bariatric surgery in the strategies of positive pulmonary ventilation, tracheal intubation technique, hemodynamic monitoring, and postoperative nausea and vomiting (PONV) prophylaxis, as the followed:

1. To evaluate the effectiveness and adverse effect of intravenous dexamethasone for PONV prophylaxis

2. To determine the safe inspiratory pressure to prevent the occurrence of gastric insufflation during facemask ventilation using point-of-care ultrasonography of antrum

3. To compare the effectiveness and safety between video intubating stylet and video laryngoscope in the placement of tracheal tubes

4. To apply minimally invasive CO monitors in guiding goal-directed hemodynamic therapy and assess its impact on major complications and postoperative recovery

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: YingHsuanTai
• Treatments: Dexamethasone

Criteria

Inclusion Criteria:

1. Age ≥ 20 years

2. Body mass index ≥ 30 kg·m-2

3. Undergoing laparoscopic sleeve gastrectomy at Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan

Exclusion Criteria:

1. Pregnant or lactating women

2. Severe cardiopulmonary distress, including left ventricular ejection fraction < 40%, double or triple vessel disease, New York Heart Association functional classification ≥ 3, peripheral oxygen saturation by pulse oximetry (SpO2) < 90% in room air, and moderate to severe pulmonary hypertension.

3. Previous esophageal, gastric, or duodenal surgery.

4. Previous head and neck surgery or radiation therapy

5. Previous cervical spine injury

6. High-degree cardiac arrythmia, including atrial fibrillation and severe atrioventricular block

7. Use of cardiac pacemaker or automated implantable cardioverter defibrillator

8. Chronic kidney disease, stage ≥ 4 (estimated glomerular filtration rate < 30 ml·min-1)

9. Planned transferal to intensive care unit for mechanical ventilation

10. QTc prolongation determined by a standard 12-lead electrocardiogram

11. Patients using emetogenic or antiemetic drugs within 24 hours before surgery

12. Patients requiring rapid sequence induction or fiberoptic awake intubation

13. Patient refusal to participate