None listed
Conditions
Brief summary
Our aim is to analyze the effects of pressure-controlled ventilation-volume guaranteed (PCV-VG) and volume controlled ventilation (VCV) on airway pressures and respiratory and circulatory indicators during laparoscopic surgery in Trendelenburg position. This is a prospective randomized comparative clinical study. Patients will be randomly allocated to either VCV group (n = 48) or the PCV-VG group (n = 48). After induction of anesthesia, for both modes of ventilation, the target tidal volume (VT) will be 8 mL/kg and the respiratory rate will be adjusted to avoid hypercarbia. The peak and mean inspiratory pressures, dynamic compliance, exhaled VT and arterial blood gas parameters will be calculated and recorded after stabilization of pneumoperitoneum, T3 and T4, 30 and 60 minutes after 30° Trendelenburg position with pneumoperitoneum respectively.
Interventions
In this study we are using a ventilation procedure for patients undergoing laparoscopic gynecologic malignancy procedures in trandelenburg position. The interventions will be delivered by the staff anesthesiologist.After induction and intubation before the initiation of surgery, patients will be assigned into two equal groups; VCV group and PCV-VG group. Ventilation settings in both groups will be
VT 8 mL/kg
Inspiratory/expiratory (I/E) ratio 1:2
Inspired oxygen concentration (FIO2) 0.5 wit
In this study we are using a ventilation procedure for patients undergoing laparoscopic gynecologic malignancy procedures in trandelenburg position. The interventions will be delivered by the staff anesthesiologist.After induction and intubation before the initiation of surgery, patients will be assigned into two equal groups; VCV group and PCV-VG group. Ventilation settings in both groups will be VT 8 mL/kg Inspiratory/expiratory (I/E) ratio 1:2 Inspired oxygen concentration (FIO2) 0.5 with air 2.0 L/min of inspiratory fresh gas flow No positive end-expiratory pressure (PEEP) Respiratory rate (RR) was adjusted to maintain an endtidal of 35 ± 2 mmHg. FiO2 0.4 CO2 pressure (ETCO2) of 35 ± 2 mmHg. In the VCV group, the ventilator settings will be continued throughout the study. In the PCV- VG group, PCV-VG mode will be chosen to achieve VT 8 mL/kg, with RR will be adjusted to maintain ETCO2 35 ± 2 mmHg. The intraperitoneal pressure will be adjusted to 12 ± 2 mmHg, and then 30° Trendelenburg position will be established.
Sponsors
Melike Korkmaz Toker
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Patients aged between 18 and 65 years, American Society of Anesthesiologists (ASA) physical status I, II or III, BMI> 30 kg/m2 undergoing laparoscopic gynecologic malignancies surgery will be enrolled in the study
Exclusion criteria
Patients suspected as difficult intubation, and have severe obstructive or restrictive pulmonary disease (defined as less than 50% of the predicted values of forced vital capacity and forced expiratory volume in 1 second) and body mass index < 30 kg/m2 will be excluded from the study.
Outcome results
None listed