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Anesthesia Endoscope Mask is Applied to Sedation Upper Gastrointestinal Endoscopic Diagnosis and Treatment

Primary Purpose

Hypoxemia

Status
Not yet recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
Routine nasal catheter group
Mask group
Sponsored by
Sichuan Provincial People's Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypoxemia focused on measuring hypoxemia, sedation, gastrointestinal sedation procedure, non-invasive ventilation, endoscopy mask

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria: Age ≥ 18 years; Upcoming upper gastrointestinal sedation procedure; Classification under the American Association of Anesthesiologists (ASA) status I-III; Baseline oxygen saturation (SpO2) ≥95% in ambient air conditions. Exclusion Criteria: Individuals with previously documented difficulties in mask ventilation (DMV); Patients predisposed to aspiration risks or episodes of vomiting; Facial or jaw injuries or congenital abnormalities that render conventional face mask application infeasible; An inability or unwillingness to utilize the novel disposable anesthesia face mask.

Sites / Locations

  • Sichuan Provincial People's Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Mask oxygen supply group

Nasal oxygen supply group

Arm Description

The anaesthesia provider supplied oxygen via a nasal cannula at an oxygen flow rate of 8L/min supplied from an oxygen flowmeter

The study team applied the mask with a head strap to ensure a proper seal,simultaneously ensuring the same oxygen flow rate as the control group

Outcomes

Primary Outcome Measures

Incidence of hypoxemia
Incidences of oxygen saturation falling below 92%

Secondary Outcome Measures

Incidence of compromised ventilation mandating primary manual intervention
For the nasal catheter cohort, this entailed jaw elevation and deploying a standard mask to augment the oxygen concentration inhaled. Concurrently, for the mask cohort, primary intervention involved mandible lifting and secure fastening of the mask sleeve for inflation (while ensuring the operational aperture remains sealed).
Incidence necessitating sophisticated manual ventilatory support during pain-free gastroscopy
If SpO2 levels further descended to ≤70% or persistently hovered below 85% for a duration exceeding 60 seconds, it mandated an immediate cessation of the ongoing procedure. The endoscope would be retracted, followed by the insertion of a standard oropharyngeal mask for assisted ventilation. In dire circumstances, the anesthesiologist might opt for advanced airway interventions, such as laryngeal mask application or endotracheal intubation.
Juxtaposition of hypoxemia onset time in both ventilation techniques
The time span from the start of drug administration by the researcher to the first occurrence of blood oxygen saturation below 92%.
the temporal span from initial decline to recovery to 92% saturation in both ventilation techniques
The time span from oxygen saturation below 92% to recovery to 92% after manual ventilatory support. If multiple episodes of hypoxia occur, all times will be added up
the lowest oxygen saturation in both ventilation techniques
the lowest oxygen saturation from the start of medication administration to the participants's Aldrete score of 9.
Evaluation of procedural prolongation due to ventilation issues
The extension time for examination is defined as the total time from stopping the operation and exiting the endoscope until the endoscope re-enters the digestive tract, to the same anatomical position before stopping the operation, If multiple episodes of withdrawal of endoscopy occur, all times will be added up
Apnea prevalence in both groups
The study here we define apnea as 10 second without obvious respiratory movements of mothorax and abdomen or snoring with paradoxical breathin
Satisfaction scores1 from patients, endoscopists, and anesthesiologists
The scores of satisfaction 1:Are you satisfied with this endoscopic diagnosis and treatment,a score of 0 represents very dissatisfied, while a score of 10 represents very satisfied.
Satisfaction scores2 from patients, endoscopists, and anesthesiologists
The scores of satisfaction2:If there is a chance, are you willing to use this non-invasive oxygen device again,a score of 0 indicates a strong unwillingness, while a score of 10 indicates a strong willingness.
The incidence of upper respiratory tract discomfort manifestations such as oral, nasal, an pharyngeal dryness and hemorrhage in two groups of participants.
Inaugural insertion success rates in two groups of participants
If the endoscopic operation fails to pass the pharynx after three attempts, recorded as the first insertion failure.

Full Information

First Posted
September 25, 2023
Last Updated
October 12, 2023
Sponsor
Sichuan Provincial People's Hospital
Collaborators
Anhui Sanhong Medical Device Technology Co., Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT06085859
Brief Title
Anesthesia Endoscope Mask is Applied to Sedation Upper Gastrointestinal Endoscopic Diagnosis and Treatment
Official Title
Anesthesia Endoscope Mask is Applied to Sedation Upper Gastrointestinal Endoscopic Diagnosis and Treatment: Multi-center, Prospective, Randomized Control, Open Clinical Research
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
October 25, 2023 (Anticipated)
Primary Completion Date
January 1, 2024 (Anticipated)
Study Completion Date
January 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Sichuan Provincial People's Hospital
Collaborators
Anhui Sanhong Medical Device Technology Co., Ltd

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
To investigate the efficacy and safety of new-type mask compared with nasal tube oxygen delivery in patients undergoing sedation of upper gastrointestinal endoscopy
Detailed Description
This study aims to utilize a large sample, multicenter, prospective clinical trial using a new mask oxygen supply technology. If the study confirms that the new mask can improve the airway safety and effectiveness in patient examinations, while improving examination efficiency and reducing failure rates, it will provide safety assurance for the early diagnosis and treatment of upper gastrointestinal diseases in high-risk populations.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypoxemia
Keywords
hypoxemia, sedation, gastrointestinal sedation procedure, non-invasive ventilation, endoscopy mask

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Randomly assign participants to the standard nasal catheter oxygenation group and the endoscopy mask oxygen inhalation group
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
1208 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Mask oxygen supply group
Arm Type
Experimental
Arm Description
The anaesthesia provider supplied oxygen via a nasal cannula at an oxygen flow rate of 8L/min supplied from an oxygen flowmeter
Arm Title
Nasal oxygen supply group
Arm Type
Experimental
Arm Description
The study team applied the mask with a head strap to ensure a proper seal,simultaneously ensuring the same oxygen flow rate as the control group
Intervention Type
Device
Intervention Name(s)
Routine nasal catheter group
Intervention Description
The anaesthesia provider supplied oxygen via a nasal cannula at an oxygen flow rate of 8L/min supplied from an oxygen flowmeter as described in the guide
Intervention Type
Device
Intervention Name(s)
Mask group
Intervention Description
The study team applied the mask with a head strap to ensure a proper seal,simultaneously ensuring the same oxygen flow rate as the control group
Primary Outcome Measure Information:
Title
Incidence of hypoxemia
Description
Incidences of oxygen saturation falling below 92%
Time Frame
From the start of drug administration by the researcher to the completely withdraw from the endoscopy by the end of the examination.
Secondary Outcome Measure Information:
Title
Incidence of compromised ventilation mandating primary manual intervention
Description
For the nasal catheter cohort, this entailed jaw elevation and deploying a standard mask to augment the oxygen concentration inhaled. Concurrently, for the mask cohort, primary intervention involved mandible lifting and secure fastening of the mask sleeve for inflation (while ensuring the operational aperture remains sealed).
Time Frame
From the start of drug administration by the researcher to the completely withdraw from the endoscopy by the end of the examination.
Title
Incidence necessitating sophisticated manual ventilatory support during pain-free gastroscopy
Description
If SpO2 levels further descended to ≤70% or persistently hovered below 85% for a duration exceeding 60 seconds, it mandated an immediate cessation of the ongoing procedure. The endoscope would be retracted, followed by the insertion of a standard oropharyngeal mask for assisted ventilation. In dire circumstances, the anesthesiologist might opt for advanced airway interventions, such as laryngeal mask application or endotracheal intubation.
Time Frame
From the start of drug administration by the researcher to the completely withdraw from the endoscopy by the end of the examination.
Title
Juxtaposition of hypoxemia onset time in both ventilation techniques
Description
The time span from the start of drug administration by the researcher to the first occurrence of blood oxygen saturation below 92%.
Time Frame
From the start of drug administration by the researcher to the completely withdraw from the endoscopy by the end of the examination.
Title
the temporal span from initial decline to recovery to 92% saturation in both ventilation techniques
Description
The time span from oxygen saturation below 92% to recovery to 92% after manual ventilatory support. If multiple episodes of hypoxia occur, all times will be added up
Time Frame
From the start of drug administration by the researcher to the completely withdraw from the endoscopy by the end of the examination.
Title
the lowest oxygen saturation in both ventilation techniques
Description
the lowest oxygen saturation from the start of medication administration to the participants's Aldrete score of 9.
Time Frame
From the start of drug administration by the researcher to the completely withdraw from the endoscopy by the end of the examination.
Title
Evaluation of procedural prolongation due to ventilation issues
Description
The extension time for examination is defined as the total time from stopping the operation and exiting the endoscope until the endoscope re-enters the digestive tract, to the same anatomical position before stopping the operation, If multiple episodes of withdrawal of endoscopy occur, all times will be added up
Time Frame
From the start of drug administration by the researcher to the completely withdraw from the endoscopy by the end of the examination.
Title
Apnea prevalence in both groups
Description
The study here we define apnea as 10 second without obvious respiratory movements of mothorax and abdomen or snoring with paradoxical breathin
Time Frame
From the start of drug administration by the researcher to the completely withdraw from the endoscopy by the end of the examination.
Title
Satisfaction scores1 from patients, endoscopists, and anesthesiologists
Description
The scores of satisfaction 1:Are you satisfied with this endoscopic diagnosis and treatment,a score of 0 represents very dissatisfied, while a score of 10 represents very satisfied.
Time Frame
Immediately after the procedure.
Title
Satisfaction scores2 from patients, endoscopists, and anesthesiologists
Description
The scores of satisfaction2:If there is a chance, are you willing to use this non-invasive oxygen device again,a score of 0 indicates a strong unwillingness, while a score of 10 indicates a strong willingness.
Time Frame
Immediately after the procedure.
Title
The incidence of upper respiratory tract discomfort manifestations such as oral, nasal, an pharyngeal dryness and hemorrhage in two groups of participants.
Time Frame
Immediately after the procedure.
Title
Inaugural insertion success rates in two groups of participants
Description
If the endoscopic operation fails to pass the pharynx after three attempts, recorded as the first insertion failure.
Time Frame
From the start of drug administration by the researcher to the completely withdraw from the endoscopy by the end of the examination.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years; Upcoming upper gastrointestinal sedation procedure; Classification under the American Association of Anesthesiologists (ASA) status I-III; Baseline oxygen saturation (SpO2) ≥95% in ambient air conditions. Exclusion Criteria: Individuals with previously documented difficulties in mask ventilation (DMV); Patients predisposed to aspiration risks or episodes of vomiting; Facial or jaw injuries or congenital abnormalities that render conventional face mask application infeasible; An inability or unwillingness to utilize the novel disposable anesthesia face mask.
Facility Information:
Facility Name
Sichuan Provincial People's Hospital
City
Chengdu
State/Province
Sichuan
Country
China

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
After December 2024, the original data can be obtained through the author's email address.
IPD Sharing Time Frame
After December 2024
IPD Sharing Access Criteria
Any project applicant
Citations:
PubMed Identifier
29298872
Citation
Behrens A, Kreuzmayr A, Manner H, Koop H, Lorenz A, Schaefer C, Plauth M, Jetschmann JU, von Tirpitz C, Ewald M, Sackmann M, Renner W, Kruger M, Schwab D, Hoffmann W, Engelke O, Pech O, Kullmann F, Pampuch S, Lenfers B, Weickert U, Schilling D, Boehm S, Beckebaum S, Cicinnati V, Erckenbrecht JF, Dumoulin FL, Benz C, Rabenstein T, Haltern G, Balsliemke M, de Mas C, Kleber G, Pehl C, Vogt C, Kiesslich R, Fischbach W, Koop I, Kuehne J, Breidert M, Sass NL, May A, Friedrich C, Veitt R, Porschen R, Ellrichmann M, Arlt A, Schmitt W, Dollhopf M, Schmidbaur W, Dignass A, Schmitz V, Labenz J, Kaiser G, Krannich A, Barteska N, Ell C. Acute sedation-associated complications in GI endoscopy (ProSed 2 Study): results from the prospective multicentre electronic registry of sedation-associated complications. Gut. 2019 Mar;68(3):445-452. doi: 10.1136/gutjnl-2015-311037. Epub 2018 Jan 3.
Results Reference
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33933271
Citation
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Results Reference
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PubMed Identifier
27126387
Citation
Goudra B, Nuzat A, Singh PM, Borle A, Carlin A, Gouda G. Association between Type of Sedation and the Adverse Events Associated with Gastrointestinal Endoscopy: An Analysis of 5 Years' Data from a Tertiary Center in the USA. Clin Endosc. 2017 Mar;50(2):161-169. doi: 10.5946/ce.2016.019. Epub 2016 Apr 29.
Results Reference
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PubMed Identifier
28974061
Citation
Qin Y, Li LZ, Zhang XQ, Wei Y, Wang YL, Wei HF, Wang XR, Yu WF, Su DS. Supraglottic jet oxygenation and ventilation enhances oxygenation during upper gastrointestinal endoscopy in patients sedated with propofol: a randomized multicentre clinical trial. Br J Anaesth. 2017 Jul 1;119(1):158-166. doi: 10.1093/bja/aex091.
Results Reference
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PubMed Identifier
2883355
Citation
Bell GD, Bown S, Morden A, Coady T, Logan RF. Prevention of hypoxaemia during upper-gastrointestinal endoscopy by means of oxygen via nasal cannulae. Lancet. 1987 May 2;1(8540):1022-4. doi: 10.1016/s0140-6736(87)92282-3.
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Terblanche NCS, Middleton C, Choi-Lundberg DL, Skinner M. Efficacy of a new dual channel laryngeal mask airway, the LMA(R)Gastro Airway, for upper gastrointestinal endoscopy: a prospective observational study. Br J Anaesth. 2018 Feb;120(2):353-360. doi: 10.1016/j.bja.2017.11.075. Epub 2017 Dec 1.
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Anesthesia Endoscope Mask is Applied to Sedation Upper Gastrointestinal Endoscopic Diagnosis and Treatment

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