Transsphenoidal Surgery for Pituitary Adenomas: Influence of the Ventilation Mode on Intraoperative Bleeding
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Surgery
- Sponsor
- Hopital Foch
- Enrollment
- 101
- Locations
- 1
- Primary Endpoint
- intraoperative bleeding
- Status
- Completed
- Last Updated
- 9 years ago
Overview
Brief Summary
The risk of bleeding is important during transsphenoidal surgery. This study aims to find if the ventilation mode, controlled pressure and controlled volume, modifies the risk of bleeding.
Detailed Description
The risk of bleeding is important during transsphenoidal surgery. This study aims to find if the ventilation mode, controlled pressure and controlled volume, modifies the risk of bleeding. * group Volume controlled ventilation: tidal volume of 7 mL/kg ideal body weight, frequency of 12 cycles/minute, I/E ratio of 1:2, no positive end expiratory pressure. Ventilatory frequency is changed if necessary to maintain end-expiratory pressure of CO2 between 35 and 40 mmHg. * group Pressure-controlled ventilation: initial pressure of 15 cm H2O, frequency of 12 cycles/minute, I/E ratio of 1:2, no positive end expiratory pressure. Pressure is modified to maintain a tidal volume of 7 mL/kg of ideal body weight and frequency ventilation is modified to maintain end-expiratory pressure of CO2 between 35 and 40 mmHg. * In both groups, the fraction of inspired oxygen is 50%. A recruitment maneuver is performed if the blood oxygen saturation became less than 92%.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Aged \> 18 years
- •Patients scheduled for transsphenoidal surgery for pituitary adenomas
Exclusion Criteria
- •Pregnancy
- •Obesity (BMI\> 35)
- •Known respiratory disease
- •Redo surgery
- •Preoperative problem with hemostasis (antiplatelet or anticoagulant treatment; constitutional disorder).
Outcomes
Primary Outcomes
intraoperative bleeding
Time Frame: 1 hour postoperatively
intraoperative bleeding is estimated by the operator (always the same) as minimal (1), low (3), with no significant change in the conduct of the surgical procedure (5) with significant change in the conduct of surgical procedure (7). Intermediate levels are used to rate the levels of intermediate severity.
Secondary Outcomes
- recruitment maneuver(one hour after surgery)
- generated plateau pressures(one hour after surgery)
- changes of ventilation mode(one hour after surgery)
- arterial desaturation(one hour after surgery)
- realisation of predefined objectives of minute ventilation(one hour after surgery)
- duration of the surgical procedure(one hour after surgery)
- endocrine healing(three months after surgery)