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Real-Time Ultrasound Detection of Left Paratracheal Esophagus on Air Entry into the Gastric Antrum in the Induction Period of General Anesthesia: A Prospective, Randomized Study

Authors Li Z, Yuan X, Deng W

Received 1 October 2020

Accepted for publication 11 January 2021

Published 28 January 2021 Volume 2021:17 Pages 103—109


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Professor Deyun Wang

Zhengping Li,* Xiaozhong Yuan,* Wei Deng

Department of Anesthesiology and Pain Medicine, The Affiliated Hospital of Jiaxing University, Jiaxing, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Wei Deng Email

Background: Positive-pressure ventilation (PPV) delivered via a facemask during anesthesia induction can result in gastric content being inhaled into the lungs. We hypothesized that the real-time ultrasound left paratracheal esophagus monitoring could more effectively reduce air entry into the stomach than real-time ultrasound monitoring of the gastric antrum (GA).
Methods: Patients were divided into two groups: study (S; n=30) and control (C; n=30) groups. During the induction of general anesthesia, mask ventilation adopts a pressure control mode. The initial ventilation pressure of both groups was 15 cmH2O. Before anesthesia induction, an ultrasonic probe was used to monitor the cross-sectional area (CSA) of the GA and the presence of gas in the stomach. During and after anesthesia induction, group S used a high-frequency ultrasound probe to observe the entry of air from the left paratracheal esophagus into the GA. The ventilation pressure was gradually reduced over time until no esophageal air was found. In group C, the ventilatory pressure was set maintained at 15 cmH2O and the CSA of the GA and air intake were monitored using an ultrasonic probe.
Results: Before and after PPV, the CSA of the GA in group S decreased (P< 0.001), whereas the CSA in group C increased (P=0.002). The GA CSA in group C after PPV was larger than in group S after PPV (P=0.002). The proportion of patients who experienced intragastric air intake in group S (23.3%) was significantly lower than that in group C (66.7) (P=0.001).
Conclusion: Compared with ultrasound monitoring of the GA, real-time ultrasound detection of LPEOAE into the GA during anesthesia induction was more effective, more sensitive, significantly reduced the prevalence of intragastric air intake, and provided sufficient tidal volume and oxygen for patients.

Keywords: left paratracheal esophagus, anesthesia, ultrasonography, gastric antrum

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