The Relationship Between Intraoperative ETCO2 Levels and Postoperative Pain and Nausea-Vomiting

Completed

• Conditions: Vomiting, Postoperative; Pain, Postoperative; Nausea, Postoperative
• Interventions: Other: Patients with high ETCO2 levels; Other: ETCO2 levels

• Registration Number: NCT06114277
• Lead Sponsor: Ankara Etlik City Hospital

Brief Summary

The aim of our study is to investigate the relationship between intraoperative ETCO2 levels and postoperative nausea-vomiting and pain scores in patients undergoing robotic laparoscopic radical prostatectomy. The investigators will monitor patients' 24-hour postoperative pain, nausea-vomiting and the consumption of additional analgesic and antiemetic medications.

Detailed Description

Robotic surgery provides several advantages in the field of surgery, including a three-dimensional view of the surgical site, the elimination of surgeon hand tremors, and enhanced precision in movements. Additionally, it offers benefits such as reduced intraoperative bleeding, faster return to daily functions for patients, and decreased hospitalization duration. Consequently, the use of robots in various surgical procedures has become widespread in contemporary medical practice.

Robot-assisted laparoscopic radical prostatectomy is a surgical technique performed in a head-down Trendelenburg position with intraperitoneal insufflation of carbon dioxide (CO2). This positioning and pneumoperitoneum lead to an increase in intraabdominal pressure, as well as elevated intracranial and intraocular pressures.

End-tidal carbon dioxide (ETCO2) levels can vary during laparoscopic surgery. An increase in ETCO2 levels has been reported to cause an elevation in intracranial pressure, leading to an increased incidence of postoperative nausea and vomiting. Some studies in the literature have investigated the relationship between ETCO2 values and the incidence of postoperative nausea and vomiting in patients. Furthermore, it is believed that hypercarbia (elevated carbon dioxide levels) may have an impact on postoperative pain.

The aim of our study is to investigate the relationship between intraoperative ETCO2 levels and postoperative nausea, vomiting, and pain scores in patients undergoing robotic laparoscopic radical prostatectomy. The investigators will monitor patients' 24-hour postoperative pain, nausea, vomiting, and the consumption of additional analgesic and antiemetic medications.

Study Timeline

• Study First Submitted: 2023-10-29
• Study First Submitted QC: 2023-10-29
• Study First Posted: 2023-11-02
• Study Start: 2024-06-10
• Primary Completion: 2024-08-02
• Study Completion: 2024-08-15
• Status Verified: 2025-05
• Last Update Submitted: 2025-05-01
• Last Update Posted: 2025-05-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Male
• Target Recruitment: 109

Inclusion Criteria

1. Individuals between the ages of 18 and 80.
2. Patients with American Society of Anesthesiologists (ASA) scores I, II, or III.
3. Patients who have undergone robotic laparoscopic prostatectomy in the operating room.

Exclusion Criteria

1. Patients under 18 years old or over 80 years old.
2. Patients with American Society of Anesthesiologists (ASA) scores IV and above.
3. Patients who refuse to participate in the study.
4. Patients undergoing emergency surgery.

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Patients with high ETCO2 levels	Patients with high ETCO2 levels	Intraoperative ETCO2 values between 36 and 45 in laparoscopic robotic prostatectomy patients were included in this group.
Patients with low ETCO2 levels	ETCO2 levels	Intraoperative ETCO2 values between 26 and 35 in laparoscopic robotic prostatectomy patients were included in this group.

Primary Outcome Measures

Name	Time	Method
Postoperative nausea and vomiting (PONV) Score	0-2-4-8-12-24 hours postoperatively	Postoperative nausea and vomiting recording in patients.; * 0=no PONV: patient reports no nausea and has had no emesis episodes; * 1=mild PONV: patient reports nausea but declines antiemetic treatment; * 2=moderate PONV: patient reports nausea and accepts antiemetic treatment; and; * 3=severe PONV: nausea with any emesis episode (retching or vomiting). Higher scores indicate severe postoperative nausea and vomitting.

Secondary Outcome Measures

Name	Time	Method
Pain on the Numeric Rating Scale (NRS)	0-2-4-8-12-24 hours postoperatively	Participants recorded pain rated on the numeric rating scale (NRS) at 6 time points. NRS range was from 0-10 with 0 being no pain and 10 the worst pain possible.

Trial Locations

Locations (1)

Ankara Etlik City Hospital; 🇹🇷 Ankara, Varlık Mahallesi, Halil Sezai Erkut Caddesi Yenimahalle, Turkey