Effect of Positive End-expiratory Pressure on Arterial Oxygen Partial Pressure in Elderly Patients Undergoing Urologic Surgery Using LMA Supreme™ in Lithotomy Position
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 68
- 试验地点
- 2
- 主要终点
- The difference of arterial oxygen partial pressure (PaO2) between group P and group Z
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 65 Years 至 79 Years（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •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
排除标准
- •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
结局指标
主要结局
The difference of arterial oxygen partial pressure (PaO2) between group P and group Z
时间窗: 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
次要结局
- 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)
研究者
Young-Kug Kim
Professor
Asan Medical Center