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The purpose of the present study is to compare the effect of PEEP on arterial oxygen partial pressure in elderly patients undergoing urologic surgery using LMA supremeâ„¢ in a lithotomy position.
Positive end-expiratory pressure (PEEP) during general anesthesia with mechanical ventilation is routinely used as a standard lung protective strategy to prevent postoperative pulmonary complications including atelectasis.
In urologic surgery, elderly patients are common. Since aging decreases the elasticity of lung tissues and allowing the collapse of small airways, old age is a risk factor for postoperative atelectasis. Lithotomy position is the preferred position in urologic surgery. However, it causes the abdominal viscera to displace the diaphragm cephalad, reducing lung compliance and resulting atelectasis. Therefore, in elderly patients undergoing urologic surgery with lithotomy position, PEEP may be essential to prevent postoperative atelectasis.
Laryngeal mask airway (LMA) has been widely used in urologic surgery with lithotomy position because of short surgical time and no necessity of administration of muscle relaxant. However, application of PEEP when using LMA is still controversy. Therefore, in the present study, we aimed to compare the effect of PEEP on arterial oxygen partial pressure in elderly patients undergoing urologic surgery using LMA supremeâ„¢ in a lithotomy position.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group P | Experimental | After LMA Supremeâ„¢ insertion, PEEP of 7 cmH2O would apply during general anesthesia with mechanical ventilation. |
|
| Group Z | No Intervention | After LMA Supremeâ„¢ insertion, PEEP would not apply during general anesthesia with mechanical ventilation. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PEEP | Other | After LMA Supremeâ„¢ insertion, it's proper position is confirmed. Then, PEEP of 7 cmH2O is applied during mechanical ventilation. |
|
| Measure | Description | Time Frame |
|---|---|---|
| The difference of arterial oxygen partial pressure (PaO2) between group P and group Z | The difference of arterial oxygen partial pressure (PaO2) between group P and group Z 1 hour after LMA insertion by arterial blood gas analysis | 1 hour after LMA insertion |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative pulmonary complications | Postoperative pulmonary complications include atelectasis, pneumothorax, bronchospasm, pneumonia, pulmonary edema, pleural effusion, respiratory failure | Up to seven days |
| Complications associated with LMA |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Young-Kug Kim, MD, PhD | Asan Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Asan medical center | Seoul | 05505 | South Korea |
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| ID | Term |
|---|---|
| D001749 | Urinary Bladder Neoplasms |
| D011471 | Prostatic Neoplasms |
| ID | Term |
|---|---|
| D014571 | Urologic Neoplasms |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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Complications associated with LMA include oropharyngolaryngeal injury and sore throat.
| 1 hour after end of surgery |
| Incidence of significant leak of LMA | Significant leak of LMA means that leak friction is more than 0.2. | At 5, 30, 60 mins after LMA insertion |
| D052776 |
| Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D001745 | Urinary Bladder Diseases |
| D014570 | Urologic Diseases |
| D052801 | Male Urogenital Diseases |
| D005834 | Genital Neoplasms, Male |
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D011469 | Prostatic Diseases |