Laparoscopy
Conditions
Keywords
Pneumoperitoneum, Trendelenburg position, intra-abdominal pressure
Brief summary
Laparoscopic surgery is now widely established.Laparoscopic surgery involves insufflation of a gas (usually carbon dioxide) into the peritoneal cavity producing a pneumoperitoneum. The raised intra-abdominal pressure of the pneumoperitoneum, alteration in the patient's position and effects of carbon dioxide absorption cause changes in physiology, especially within the cardiovascular and respiratory systems.
Detailed description
The study will be carried out after approval of the ethical committee of Faculty of Medicine, Assiut University. A full preoperative anesthetic assessment will be carried out. Particular attention to the cardiovascular and respiratory systems is essential because of potential effects of the pneumoperitoneum and patient position.
Interventions
PROCEDURELaparoscopic Surgery
Insufflation of a gas (carbon dioxide) into the peritoneal cavity producing a pneumoperitoneum will be done. The positioning of the patients in Trendelenburg position will be done. intraoperative and postoperative outcomes will be assesed
Sponsors
Assiut University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 50 Years
Inclusion criteria
1. Age range 18-50 2. ASA 1 3. Elective gynecological laparoscopic surgery
Exclusion criteria
1. Severe ischemic or valvular heart disease 2. Increased intracranial pressure (e.g. Hydrocephalus, Cerebral tumor, Head injury) 3. Hepatic or renal impairment 4. Emergency surgery 5. Open surgery 6. Previous abdominal surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| mean arterial blood pressure | within the duration of the operation | mean arterial blood pressure will be monitored at different times |
| Pulmonary function tests | within the first 24 hours | forced expiratory volume at one second |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Intra-abdominal pressure | within the first 24 hours | Intra-abdominal pressure by direct measurement and indirect by Foley´s catheter will be monitored at different times (Cm water) |
| PaO2 | within the first 24 hours | PaO2 will be monitored at different times |
| Analgesic requirement | within the first 24 hours | Analgesic requirement will be monitored at different times by special scale (VAS) |
| Postoperative nausea and vomiting | within the first 24 hours | Postoperative nausea and vomiting will be monitored at different times by special scale |
| Arterial to end-tidal PaCO2- difference | within the first 24 hours | Arterial to end-tidal PaCO2- difference will be monitored at different times |
Countries
Egypt
Outcome results
None listed