Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Gas exchange disturbance frequently occurs in steep Trendelenburg position during robot-assisted laparoscopic prostatectomy or cystectomy. Due to increased intrathoracic pressure and absorbed carbon dioxide (CO2) gas insufflated into abdominal cavity, hypercapnia as well as hypoxia may occur. Inverse ratio ventilation or prolonged inspiratory time during mechanical ventilation has been reported to be improve gas exchange in adult respiratory distress syndrome. The investigators attempt to test the hypothesis that prolonged inspiratory time may improve the gas exchange during robot-assisted laparoscopic urologic surgery.
Gas exchange disturbance frequently occurs in steep Trendelenburg position during robot-assisted laparoscopic prostatectomy or cystectomy. Due to increased intrathoracic pressure and absorbed CO2 gas insufflated into abdominal cavity, hypercapnia as well as hypoxia may occur. Inverse ratio ventilation or prolonged inspiratory time during mechanical ventilation has been reported to be improve gas exchange in adult respiratory distress syndrome. The investigators attempt to test the hypothesis that prolonged inspiratory time (I:E ratio = 1:1) may improve the gas exchange during robot-assisted laparoscopic urologic surgery.
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1:2, 1:1 group | Experimental | Inspiratory to expiratory time ratio (I:E ratio) of 1:2 during the first one hour of laparoscopy and then switched to I:E ratio of 1:1 during the rest time of laparoscopy. |
|
| 1:1, 1:2 group | Active Comparator | Inspiratory to expiratory time ratio (I:E ratio) of 1:1 during the first one hour of laparoscopy and then switched to I:E ratio of 1:2 during the rest time of laparoscopy. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Adjustment of Mechanical Ventilator Inspiratory to expiratory time ratio (1:2 to 1:1) | Device | Adjustment of Mechanical Ventilator Inspiratory to expiratory time ratio (1:2 to 1:1) |
| Measure | Description | Time Frame |
|---|---|---|
| PaCO2 (mmHg) in the patient's arterial blood gas analysis | PaCO2 (arterial partial pressure of carbon dioxide) | 60 min after the initiation of pneumoperitoneum with steep Trendelenburg positioning |
| Measure | Description | Time Frame |
|---|---|---|
| PaCO2 (mmHg) in the patient's arterial blood gas analysis | PaCO2 (arterial partial pressure of carbon dioxide) | 5 minutes after anesthesia induction |
| PaO2 (mmHg) in the patient's arterial blood gas analysis |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Seoul National University Hospital | Seoul | 03080 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25277444 | Background | De Carlo F, Celestino F, Verri C, Masedu F, Liberati E, Di Stasi SM. Retropubic, laparoscopic, and robot-assisted radical prostatectomy: surgical, oncological, and functional outcomes: a systematic review. Urol Int. 2014;93(4):373-83. doi: 10.1159/000366008. Epub 2014 Sep 23. | |
| 22415437 | Background | Gainsburg DM. Anesthetic concerns for robotic-assisted laparoscopic radical prostatectomy. Minerva Anestesiol. 2012 May;78(5):596-604. Epub 2012 Mar 13. |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Adjustment of Mechanical Ventilator Inspiratory to expiratory time ratio (1:1 to 1:2) | Device | Adjustment of Mechanical Ventilator Inspiratory to expiratory time ratio (1:1 to 1:2) |
|
PaO2 (arterial partial pressure of oxygen)
| 5 minutes after anesthesia induction |
| PaO2 (mmHg) in the patient's arterial blood gas analysis | PaO2 (arterial partial pressure of oxygen) | 60 minutes after anesthesia induction |
| PaCO2 (mmHg) in the patient's arterial blood gas analysis | PaCO2 (arterial partial pressure of carbon dioxide) | 120 minutes after anesthesia induction |
| PaO2 (mmHg) in the patient's arterial blood gas analysis | PaO2 (arterial partial pressure of oxygen) | 120 min after the initiation of pneumoperitoneum with steep Trendelenburg positioning |
| PaCO2 (mmHg) in the patient's arterial blood gas analysis | PaCO2 (arterial partial pressure of carbon dioxide) | 10 min after restoration of supine position |
| PaO2 (mmHg) in the patient's arterial blood gas analysis | PaO2 (arterial partial pressure of oxygen) | 10 min after restoration of supine position |
| Respiratory compliance (Static, Dynamic) | Static compliance = exhaled tidal volume / (plateau pressure - PEEP), Dynamic compliance = Exhaled tidal volume / (PIP - PEEP) | 5 minutes after anesthesia induction |
| Respiratory compliance (Static, Dynamic) | Static compliance = exhaled tidal volume / (plateau pressure - PEEP), Dynamic compliance = Exhaled tidal volume / (PIP - PEEP) | 60 min after the initiation of pneumoperitoneum with steep Trendelenburg positioning |
| Respiratory compliance (Static, Dynamic) | Static compliance = exhaled tidal volume / (plateau pressure - PEEP), Dynamic compliance = Exhaled tidal volume / (PIP - PEEP) | 120 min after the initiation of pneumoperitoneum with steep Trendelenburg positioning |
| oxygen index | oxygen index calculated by PaO2/inspired oxygen fraction | 5 minutes after anesthesia induction |
| oxygen index | oxygen index calculated by PaO2/inspired oxygen fraction | 60 min after the initiation of pneumoperitoneum with steep Trendelenburg positioning |
| oxygen index | oxygen index calculated by PaO2/inspired oxygen fraction | 120 min after the initiation of pneumoperitoneum with steep Trendelenburg positioning |
| Alveolar-arterial oxygen difference | 5 minutes after anesthesia induction |
| Alveolar-arterial oxygen difference | 60 min after the initiation of pneumoperitoneum with steep Trendelenburg positioning |
| Alveolar-arterial oxygen difference | 120 min after the initiation of pneumoperitoneum with steep Trendelenburg positioning |
| 25869025 | Background | Kim MS, Kim NY, Lee KY, Choi YD, Hong JH, Bai SJ. The impact of two different inspiratory to expiratory ratios (1:1 and 1:2) on respiratory mechanics and oxygenation during volume-controlled ventilation in robot-assisted laparoscopic radical prostatectomy: a randomized controlled trial. Can J Anaesth. 2015 Sep;62(9):979-87. doi: 10.1007/s12630-015-0383-2. Epub 2015 Apr 14. |
| ID | Term |
|---|---|
| D011471 | Prostatic Neoplasms |
| D001749 | Urinary Bladder Neoplasms |
| ID | Term |
|---|---|
| D005834 | Genital Neoplasms, Male |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D011469 | Prostatic Diseases |
| D052801 | Male Urogenital Diseases |
| D014571 | Urologic Neoplasms |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D001745 | Urinary Bladder Diseases |
| D014570 | Urologic Diseases |
Not provided
Not provided