Chest Ultrasonography for assessing degree of lung collapse during Robotic lower abdominal Surgeries.

Completed

• Conditions: Patients posted for robotic pelvic surgeries (ASA I,II,III) with duration of surgery more than 2 hours , requiring pneumoperitoneum and steep trendelenburg position.

• Registration Number: CTRI/2018/01/011516
• Lead Sponsor: Rajiv Gandhi Cancer Institiute and Research Centre

Brief Summary

Introduction  - General anaesthesia results in developement  of  atelectasis in dependent areas of the  lungs exposing patients to an increased risk of hypoxaemia.During  pelvic robotic surgeries pneumoperitoneum and steep trendelenburgh  position further  increases atelectasis. Lung Ultrasound imaging is a promising , noninvasive , non-radiant, portable tool to study intraoperative lung atelectasis.

**Type of Study :**This study is prospective, interventional,observational single centre study.

**Aims and Objectives** ( i ) To study the degree of anaesthesia induced atelectasis with Lung Ultrasound Imaging  in patients undergoing pelvic robotic surgery. (ii) To demonstrate a link between a four point lung aeration score and Pao2 /Fio2  Ratio  . **Procedure** -In OT Standard monitoring will be attached ,under LA  radial artery cannulation will be performed  , Conventional  general anesthesia with oral cuffed ETT and IPPV wil be provided to all patients.

**T1** -Baseline Lung Ultrasound Imaging  using 4 point Lung aeration score ( 0= Normal lung , 1= moderate aeration loss, 2=severe  aeration loss ,3=complete aeration loss and consolidation. will be noted in 3 basal zones in both lungs 5 minutes after induction of anaesthesia  and before docking robotic instruments. **T2** Lung Ultrasound Imaging and aeration score noted at the end of robotic surgery 5 minutes after dedocking robotic instruments in 3 basal zones in both lungs.**Ta** Arterial blood gas 5 minutes after induction of anesthesia and before docking robotic instruments.**Tb** -Arterial blood gas 5 minutes after the end of  robotic surgery and dedocking robotic instruments.All patients will recieve PEEP 5 cms H2O intraoperatively . Any decrease in Oxygen saturation and intervention required will be noted.  Expected  primary outcome To diagnose  degree of lung atelectasis in robotic pelvic surgeries with lung aeration score more than 1 in basal areas .Secondary outcome decrease in PaO2 / Fio2 ration at the end of pelvic robotic surgery compared to baseline values.

Detailed Description

Not available

Study Timeline

• Study Start: 2015-12-28
• Study Completion: 2017-12-28
• Last Update Posted: 2018-01-20

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 50

Inclusion Criteria

Patients scheduled for robotic pelvic surgeries under general anesthesia requiring pneumoperitoneum and steep trendelenberg position .

Exclusion Criteria

Preoperative lung consolidation, severe COPD, previous thoracic procedure, BMI>28, cardiomyopathy with decreased systolic ejection fraction.

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
To estimate degree of lung atelectasis using aeration score by ultrasound imaging .	T1 - Baseline Lung US Imaging in 6 basal zones and aeration score (3 in each lung )5 minutes after induction of anaesthesia and before docking of robotic instruments. | T2 - Lung US Imaging in 6 basal zones and aeration score (3 in each lung ) 5 minutes after the end of robotic surgery and dedocking of robotic instruments.

Secondary Outcome Measures

Name	Time	Method
To assess impact of robotic surgery on gas exchange by measuring arterial blood gases.	Ta - ABG 5 minutes after induction of anaesthesia and before docking of robotic intruments.

Trial Locations

Locations (1)

Rajiv Gandhi Cancer Institute and Research Centre.; 🇮🇳 North, DELHI, India

Rajiv Gandhi Cancer Institute and Research Centre.

🇮🇳North, DELHI, India

Dr Anita Kulkarni MD

Principal investigator

09891064785

anitackulkarni@gmail.com