Obesity, Morbid Clinical Trial
Official title:
The Effect of Automatic Recruitment Maneuver on Peroperative Lung Mechanics and Postoperative Kidney Functions of Obese Patients Undergoing Laparoscopic Abdominal Surgery
This study aims to demonstrate the effects of automatic recruitment maneuver on peroperative
lung mechanics of obese patients undergoing laparoscopic abdominal surgery.
128 obese patients undergoing abdominal laparoscopic surgery are randomly going to be
assigned to automatic recruitment maneuver group and no recruitment maneuver group (control
group). Both groups are going to be taken to the operating table. Electrocardiography (ECG),
noninvasive blood pressure (NIBP), pulse oximeter and peripheral oxygen saturation (SpO2) and
post-intubation end-tidal carbon dioxide (EtCO2) and train of four (TOF) monitoring will be
performed. Then, general anesthesia induction procedure will be started. Following
intubation, patients will be ventilated according to the ideal weight within the scope of
intraoperative protective ventilation strategy and in pressure-controlled ventilation (PCV)
mode. Then, automatic recruitment maneuver will be applied to the recruitment group twice,
after insufflation and desufflation. It will not be applied to the control group. During
recruitment maneuver, PEEP (Positive end-expiratory pressure), where dynamic compliance is
measured highest, will be the ideal PEEP (Positive end-expiratory pressure) for the patient,
and PEEP (Positive end-expiratory pressure) will be adjusted at this value after recruitment.
If MAP (mean arterial pressure) is <60 mmHg during the maneuver, the maneuver will be
terminated and these patients will be excluded from the study. Respiratory mechanics for both
groups (peak pressure, plateau pressure, driver pressure, static compliance, dynamic
compliance, EtCO2) and hemodynamic parameters (heart peak, mean arterial pressure, SpO2) at 5
different times (T1: post intubation; T2 : after insufflation; T3: 5 minutes after
insufflation / after the first recruitment maneuver; T4: after desufflation; T5: 5 minutes
after desufflation / after the second recruitment maneuver) will be recorded. Throughout the
surgery, insufflation pressure will be kept as 10-13 cmH20. At the end of the surgery, the
anesthesia maintenance of all patients will be terminated and the routine wake-up phase will
be initiated. Creatinine values and hourly urine outputs of all patients routinely monitored
at the postoperative 24th hour will be recorded on the case follow-up form.
n/a
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