Morbid Obesity, Hemodynamic Instability, Bariatric Surgery Candidate
Conditions
Keywords
Morbidly obese patients, Bariatric surgery, Arterial blood analysis
Brief summary
Low-flow anesthesia has been used for years with positive results, but its effects on hemodynamic parameters and oxygenation are not clearly known in high-risk morbidly obese patients who are prone to pulmonary dysfunction related to the obesity. Therefore, this prospective randomized study aimed to compare the effects of low-flow (0.75 L/min) and normal-flow (1.5 L/min) anesthesia on hemodynamic parameters and oxygenation in morbidly obese patients undergoing laparoscopic bariatric surgery.
Detailed description
Low-flow anesthesia has several potential benefits. It improves the flow dynamics of the inhaled air, increase mucociliary clearance, maintain body temperature, reduce fluid loss, result in savings of up to 75% and reduce greenhouse gas emissions and reduce treatment costs (10 - 13). However, it is necessary to examine whether the reduction of fresh gas flow affects the quality and safety of anesthesia management, especially during high-risk operations such as laparoscopic bariatric surgery. Low-flow anesthesia has been used for years with positive results, but its effects on hemodynamic parameters and oxygenation are not clearly known in high-risk morbidly obese patients who are prone to pulmonary dysfunction related to the obesity. Therefore, this prospective randomized study aimed to compare the effects of low-flow (0.75 L/min) and normal-flow (1.5 L/min) anesthesia on hemodynamic parameters and oxygenation in morbidly obese patients undergoing laparoscopic bariatric surgery.
Interventions
DIAGNOSTIC_TESThemodynamic parameters
vital signs on the monitor including heart rate, mean arterial pressure, peripheral oxygen saturation and End-tidal Carbon Dioxide
DIAGNOSTIC_TESTarterial blood gase
Arterial blood gas including partial oxygen pressure and partial carbon dioxide pressure is an important routine investigation to monitor the acid-base balance of patients, effectiveness of gas exchange, and the state of their voluntary respiratory control.
Sponsors
Inonu University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SCREENING
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Morbidly obese patients with American Society of Anesthesiology (ASA) scores of III-IV, * Aged 18-65 years old, * BMI\>40
Exclusion criteria
* Pregnant * Uncontrolled diabetes mellitus, * Cardiovascular disease, * Pulmonary disease, * Cerebrovascular disease, * Drug and alcohol addiction.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The level of partial oxygen pressure | From beginning of Anesthesia induction to the end of anesthesia (during perioperative period) | The level of partial oxygen pressure is measured as mmHg in arterial blood gase analysis |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Heart rate | From beginning of Anesthesia induction to the end of anesthesia (during perioperative period) | Heart rate is measured as beats/minute on the anesthesia monitor |
| Mean arterial pressure | From beginning of Anesthesia induction to the end of anesthesia (during perioperative period) | Mean arterial pressure is measured as mmHg on the anesthesia monitor |
| Peripheral oxygen saturation | From beginning of Anesthesia induction to the end of anesthesia (during perioperative period) | Peripheral oxygen saturation is measured as percentage (%) on the anesthesia monitor |
Countries
Turkey (Türkiye)
Outcome results
None listed