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During shoulder arthroscopic surgery, extravasation of irrigation fluid can occur around the shoulder and trachea, compressing the upper airway. Although the extravasation is generally reabsorbed asymptomatically within 12 hours, there are cases that lead to reintubation or life-threatening complications. Furthermore, the soft tissue edema around the shoulder may extend to the thoracic cage, compress the chest and induce the respiratory distress immediately after surgery. The investigators attempt to determine the effect of shoulder arthroscopic surgery on respiratory mechanics. Changes in respiratory mechanics and arterial blood gases were measured and compared before and after the shoulder arthroscopic surgery.
Currently, most shoulder surgeries are performed with arthroscopy. The advantages of shoulder arthroscopic surgery are decreased blood loss due to minimal incision for scope, a reduced operation time, minimization of surgical stress, and rapid recovery time after surgery. During shoulder arthroscopic surgery, extravasation of irrigation fluid can occur around the shoulder and trachea, compressing the upper airway. Although the extravasation is generally reabsorbed asymptomatically within 12 hours, there are cases that lead to reintubation or life-threatening complications. Furthermore, the soft tissue edema around the shoulder may extend to the thoracic cage, compress the chest and induce the respiratory distress immediately after surgery. From these facts, the mechanism of respiratory discomfort after shoulder arthroscopic surgery may be because the upper airway obstruction or restrictive pathology due to direct compression of thoracic cage by the soft tissue edema. There have been no studies on the respiratory effect of shoulder arthroscopic surgery. We have observed frequent and severe respiratory discomfort after the shoulder arthroscopic surgery. Therefore, in this study we attempt to determine the effect of shoulder arthroscopic surgery on respiratory mechanics. Changes in respiratory mechanics and arterial blood gases were measured and compared before and after the shoulder arthroscopic surgery.
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| Measure | Description | Time Frame |
|---|---|---|
| Static compliance | Static compliance (mL/cmH2O) before and after the arthroscopic surgery ,Static compliance = tidal volume delivered / (plateau pressure - PEEP) | before and after arthroscopic surgery, an expected average of 80 minutes |
| dynamic compliance | dynamic compliance (mL/cm H2O) before and after the arthroscpic surgery ,dynamic compliance = tidal volume delivered / (peak pressure - PEEP) | before and after arthroscopic surgery, an expected average of 80 minutes |
| Measure | Description | Time Frame |
|---|---|---|
| inspiratory tidal volume | inspiratory tidal volume (ml) before and after the arthroscpic surgery | before and after arthroscopic surgery, an expected average of 80 minutes |
| expiratory tidal volume |
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Inclusion Criteria:
Exclusion Criteria:
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patients undergoing arthroscopic shoulder rotator cuff repair surgery
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| Name | Affiliation | Role |
|---|---|---|
| Mi Sook Gwak, M.D.,Ph.D. | Samsung Medical Center | Principal Investigator |
| Won Ho Kim, M.D. | Samsung Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Samsung Medical Center | Seoul | 135-710 | South Korea |
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| ID | Term |
|---|---|
| D000402 | Airway Obstruction |
| ID | Term |
|---|---|
| D012131 | Respiratory Insufficiency |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
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expiratory tidal volume (ml) before and after the arthroscpic surgery
| before and after arthroscopic surgery, an expected average of 80 minutes |
| peak inspiratory pressure | peak inspiratory pressure (cm H2O) before and after the arthroscpic surgery | before and after arthroscopic surgery, an expected average of 80 minutes |
| physiologic dead space | physiologic dead space (VD/VT) before and after arthroscopic surgery ,VD/VT = (PaCO2 - PeCO2)/PaCO2, PeCO2 = mixed expired CO2 | before and after arthroscopic surgery, an expected average of 80 minutes |
| plateau airway pressure | plateau airway pressure (cmH2O) before and after arthroscopic surgery | before and after arthroscopic surgery, an expected average of 80 minutes |
| Mean airway pressure | Mean airway pressure (cm H2O) before and after arthroscopic surgery | before and after arthroscopic surgery, an expected average of 80 minutes |
| positive end expiratory pressure | positive end expiratory pressure (cmH2O) before and after arthroscopic surgery | before and after arthroscopic surgery, an expected average of 80 minutes |
| inspiratory resistance | inspiratory resistance (cmH2O/L sec) before and after arthroscopic surgery | before and after arthroscopic surgery, an expected average of 80 minutes |
| expiratory resistance | expiratory resistance (cmH2O/ L sec)before and after arthroscopic surgery | before and after arthroscopic surgery, an expected average of 80 minutes |
| peak inspiratory flow | peak inspiratory flow (L/min) before and after arthroscopic surgery | before and after arthroscopic surgery, an expected average of 80 minutes |
| peak expiratory flow | peak expiratory flow (L/min) before and after arthroscopic surgery | before and after arthroscopic surgery, an expected average of 80 minutes |
| Work of breathing | Work of breathing (J/L) before and after arthroscopic surgery | before and after arthroscopic surgery, an expected average of 80 minutes |
| end tidal CO2 | end tidal CO2 (mmHg) before and after arthroscopic surgery | before and after arthroscopic surgery, an expected average of 80 minutes |
| arterial oxygen tension | arterial oxygen tension (mmHg) measured by arterial blood gas analysis | before and after arthroscopic surgery, an expected average of 80 minutes |
| arterial CO2 tension | arterial CO2 tension (mmHg)as measured by arterial blood gas analysis | before and after arthroscopic surgery, an expected average of 80 minutes |
| forced vital capacity (FVC) | forced vital capacity measured by portable spirometry | before and after general anesthesia, an expected average of 120 minutes |
| forced expiratory volume for 1 second (FEV1) | forced expiratory volume for 1 second (FEV1)measure by portable spirometry | before and after general anesthesia, an expected average of 120 minutes |