Comparison of the effect of ultrasound guided and conventional lung recruitment manoeuvres in trendelenburg robotic surgery

This study is a prospective, randomised, interventional, and comparative study to compare the effect of ultrasound guided and conventional lung recruitment manoeuvres in patients undergoingTrendelenburg robotic surgery, with the hypothesis that ultrasound guided recruitment manoeuvres have better efficacy as compared to the conventional lung recruitment manoeuvres. A baseline lung ultrasound score will be calculated before the induction of anaesthesia. In both the groups lung ultrasound examination will be done at two predefined time points ,five minutes after the induction of anesthesia and five minutes before extubation. After lung  ultrasound examination, recruitment manoeuvres will be performed. In one group recruitment manoeuvres will be performed under direct real time  guidance of ultrasound where in manual inflation will be applied till no collapse area is visible on the ultrasound. The maximum airway pressure will be adjusted 40 cm H2O. In the sustained inflation group recruitment manoeuvre will be performed by manual inflation with pressure of 30 cm for 10 seconds. Lung ultrasound score will be calculated 30 minutes after extubation when the patient is in recovery room. Patient will be observed in postop ward for one hour.