Effect of Positive End-expiratory Pressure on Arterial Oxygen Partial Pressure in Elderly Patients Undergoing Urologic Surgery Using LMA Supreme™ in Lithotomy Position
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Urinary Bladder Neoplasms
- Sponsor
- Asan Medical Center
- Enrollment
- 68
- Locations
- 1
- Primary Endpoint
- The difference of arterial oxygen partial pressure (PaO2) between group P and group Z
- Status
- Completed
- Last Updated
- 8 years ago
Overview
Brief Summary
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 supreme™ in a lithotomy position.
Detailed Description
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 supreme™ in a lithotomy position.
Investigators
Young-Kug Kim
Professor
Asan Medical Center
Eligibility Criteria
Inclusion Criteria
- •Patients undergoing urologic surgery with lithotomy position under general anesthesia
- •Elderly patients (65 ≤ Age \< 80)
- •American Society of Anesthesiologists (ASA) physical status: 1-3
- •Patients who voluntarily agreed to participate in this clinical study
Exclusion Criteria
- •Heart failure (ejection fraction ≤ 40%)
- •Hemodynamic instability during perioperative period
- •Lung diseases (chronic obstructive pulmonary disease, asthma, bullae, pleural effusion)
- •Obesity (BMI ≥ 30 kg/m2)
- •Neck or upper respiratory tract pathologies
- •An increased risk of pulmonary aspiration
- •Anticipation of the difficult laryngeal mask fixation due to poor dentition
Outcomes
Primary Outcomes
The difference of arterial oxygen partial pressure (PaO2) between group P and group Z
Time Frame: 1 hour after LMA insertion
The difference of arterial oxygen partial pressure (PaO2) between group P and group Z 1 hour after LMA insertion by arterial blood gas analysis
Secondary Outcomes
- Postoperative pulmonary complications(Up to seven days)
- Incidence of significant leak of LMA(At 5, 30, 60 mins after LMA insertion)
- Complications associated with LMA(1 hour after end of surgery)