A Clinical study to compare the effects of Different Positive End Expiratory Pressure on improving oxygenation during Prone Positioning underGeneral Anaesthesia.
- Conditions
- Other intraoperative and postprocedural complications and disorders of musculoskeletal system, not elsewhere classified, (2) ICD-10 Condition: O||Medical and Surgical,
- Registration Number
- CTRI/2021/11/038109
- Lead Sponsor
- srm medical college hospital
- Brief Summary
After obtaining the scientific committee and ethical committee clearance, informed consent written in their own language will be obtained from all the patients Included in the study. Study will be done on patients who are posted for elective surgery for spine fixation under prone positioning in SRM MEDICAL COLLEGE HOSPITAL AND RESEARCH CENTER, KATANKULLATHUR. Study will be performed as a prospective randomized single-blinded control studyin patients undergoing elective Spine instrumentation surgeries in prone position under general anaesthesia.. Patients will be randomized into three groups by computer generated random numbers and kept in a sealed, opaque envelope.
Group A: No PEEP
Group B: PEEP of 5.
Group C: PEEP of 10.
General anaesthesia will be standardized in all the groups. The patients will be premedicated with alprazolam on the night and two hours before surgery. The patients will be monitored with pulse oxymeter, NIBP, ECG and capnography. Glycopyraollate 0.2mg + Ondansetron 4mg IV will be administered. Morphine 0.15mg/kg will be used as the intraoperative analgesic. Propofol 2 mg/kg is the induction agent and vecuronium 0.1mg/kg is used for intubation. Anaesthesia will be maintained with O2: air with sevoflurane. Patient will be ventilated with Pressure Controlled Ventilation (PCV) to achieve a tidal volume of 7 ml/kg. Respiratory rate will be kept at 12/min. ETCO2 between 36 and 40. The amount of PEEP will be kept according to the group allotted. Three different timelines will be used to monitor the arterial po2, Peak pressure, plateau pressure and mean pressure, dynamic compliance: before induction (T1), 30 min after prone positioning (T2), and arterial po2 will be seen 30 mins after extubation. Arterial line will be inserted after shifting the patient to OT. ABG will be taken at the three time lines to look for pH, PO2, and PCO2. The Peak pressure, plateau pressure and mean pressure, dynamic compliance will be measured every 15 min intraoperatively. The haemodynamic parameters like HR and MAP will also be measured every 15 min intraoperatively. The total intraoperative blood loss will be calculated at the end of surgery in all three groups. If MAP reduces by more than 20% from baseline, it will be considered as hypotension. Hypotension will be treated initially with crystalloids and ephedrine in increments of 6mg if necessary.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Not Yet Recruiting
- Sex
- All
- Target Recruitment
- 102
patient undergoing elective spine instrumentation surgeries in prone posistion.
- patient who refuse to participate,pt.
- with hepatic dysfunction,renal dysfunction,bleeding siorders,lactating mothers.
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method arterial oxygenation 30 min after surgery
- Secondary Outcome Measures
Name Time Method peak preesure,plateau preesure,mean arterial pressure. hemodynamic parameters
Trial Locations
- Locations (1)
srm medical college hospital and research centre
🇮🇳Kancheepuram, TAMIL NADU, India
srm medical college hospital and research centre🇮🇳Kancheepuram, TAMIL NADU, IndiaRAJAGOPALAN VENKATRAMANPrincipal investigator9894581455drvenkat94@gmail.com