Application of Protective Ventilation Improves Oxygenation During and After Anesthesia. Is it Possible That a Special Procedure, an Oxygenation Test, Can Replace Arterial Blood Gases When Evaluating Oxygenation?
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Morbid Obesity
- Sponsor
- Region Västmanland
- Enrollment
- 40
- Locations
- 1
- Primary Endpoint
- Change in peripheral O2 saturation(SpO2)during and 1 hour after anesthesia in comparison to awake before anesthesia.
- Status
- Completed
- Last Updated
- 11 years ago
Overview
Brief Summary
The study investigates if applying a special ventilatory strategy during anesthesia for laparoscopic gastric by pass, produces less atelectasis and better oxygenation in spite of using 100 % oxygen during pre oxygenation and induction of anesthesia. The study investigates oxygenation with blood gas samples but also with a new method that might give more information without the use of blood gas samples.
Primary: Oxygenation in patients with morbid obesity improves if preoxygenation, induction and maintenance of anesthesia is performed with either a continuous positive airway pressure (CPAP) or a positive end expiratory pressure (PEEP), respectively, of 10 cm H2O, in comparison to a technique without CPAP but with a PEEP of 10 cm H2O.
Secondary: The improved oxygenation during anesthesia can be prolonged inte the postoperative period if emergence from anesthesia is performed without high levels of oxygen.
Investigators
Lennart Edmark
Principal Investigator
Region Västmanland
Eligibility Criteria
Inclusion Criteria
- •Adult patients scheduled for elective surgery of Morbid Obesity.
- •(ASA = American Society of Anesthesiologists classification).
- •"Body mass index" (BMI) ≥ 35 but \< 50
Exclusion Criteria
- •Anticipated difficult intubation.
- •Major bleeding.
- •Problems with ventilation necessitating protocol aberrations.
- •Obstructive sleep apnea syndrome with CPAP treatment at home.
- •Angina Pectoris
Outcomes
Primary Outcomes
Change in peripheral O2 saturation(SpO2)during and 1 hour after anesthesia in comparison to awake before anesthesia.
Time Frame: Change in SpO2 from 5 min before start of anesthesia, to 5 min after intubation, 5 min before extubation and 1 hour after extubation.
During anesthesia SpO2 is measured at three different levels of oxygen; 21, 26 and 31 % respectively as long as SpO2 does not go lower than 87 % and compared to SpO2 immediately before anesthesia. SpO2 breathing air one hour after anesthesia is compared to SpO2 before anesthesia.
Secondary Outcomes
- Arterial blood gas values for saturation (SaO2)(5 min before anesthesia, 5 min after intubation, 5 min before extubation and 1 hour after anesthesia.)
- Arterial oxygen tension (PaO2)(5 min before start of anesthesia, 5 min after intubation, 5 min before extubation and 1 hour after extubation.)