Prostate Cancer
Conditions
Brief summary
Steep trendelenburg posture or pneumoperitoneum for surgery causes ventilation problems during surgery, so finding a way to overcome is a challenging task for anesthesiologists. In this study, for patients undergoing robot assisted laparoscopic prostatectomy under general anesthesia, anesthesia is going to perform by applying conventional positive end-expiratory pressure (PEEP 5cmH2O) or individually determined positive end-expiratory pressure values for each patient using electrical impedance tomography. We plan to compare intraoperative ventilation through arterial blood gas analysis to find out the way to improve intraoperative ventilation.
Interventions
DEVICEconventional PEEP
Maintain positive end expiratory pressure at 5 cmH2O throughout the surgery.
DEVICEoptimized PEEP
Immediately after induction of anesthesia, the patient remains unapplied to PEEP. After pneumoperitoneum + Trendelenburg posture, an appropriate PEEP value is derived using electrical impedance tomography (airtom®). And then derived value ( = optimized PEEP value) is applied until the end of the operation.
Sponsors
Gangnam Severance Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
MALE
Age
20 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
1. 20 - 70 years of age who are scheduled for robotic assisted laparoscopic prostatectomy at the Department of Urology, Gangnam Severance Hospital, 2. ASA-PS (American Society of Anesthesiology Body Rating) I-IlI, 3. Patients with a BMI of 35 kg/m2 or less
Exclusion criteria
1. Patients with lung disease 2. BMI \>35kg/m2 3. Patients for whom positive end-tidal pressure cannot be applied (large bullae, severe cardiac disease) 4. patient refusal
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| PaO2/FiO2 | end of surgery (before extubation) | PaO2/FiO2 is the ratio of arterial oxygen partial pressure (PaO2) to oxygen fraction (FiO2), and is a commonly used indicator for evaluating pulmonary ventilation and diagnosing lung damage. Using this index, it is possible to determine whether oxygen obtained through the lungs is well delivered to the blood or not. It can be easily obtained by arterial blood gas analysis without complicated formulas or graphs. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ROI (region of interests) | 15 minutes after intubation, 1 hour after pnemoperitoneum, end of surgery (before extubation) | region of interest using EIT |
| inhomogeneity index | 15 minutes after intubation, 1 hour after pnemoperitoneum, end of surgery (before extubation) | inhomogeneity index : this index calculated from tidal EIT images representing the difference in impedance between the end of inspiration and the end of expiration. |
| PaO2/FiO2 | 15 minutes after intubation, 1 hour after pnemoperitoneum | partial pressure (PaO2) to oxygen fraction (FiO2), and is a commonly used indicator for evaluating pulmonary ventilation and diagnosing lung damage. Using this index, it is possible to determine whether oxygen obtained through the lungs is well delivered to the blood or not. It can be easily obtained by arterial blood gas analysis without complicated formulas or graphs. |
| total dose of vasopressor administered during surgery | end of surgery | — |
| length of hospitalization after surgery | 1 month after surgery | — |
| total amount of fluid administered during surgery | end or surgery | — |
Countries
South Korea
Contacts
Primary ContactChul-Ho Chang
Outcome results
None listed